<614.09 

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1887-97 

Inc. 


binding  POSTS  CAN  rb  m,T 

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personnel  can  remove  plastic  posts. 


On.  Lib. 

ABSTRACT  OF  PROCEEDINGS 


OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


REGULAR  MEETING,  JANUARY^,  of  ^ 

JUN  25  1951 

, The  regular  quarterly  meeting  of  the  Michigan  fHHe^  Board  oPllokftiP&u 
held  in  the  State  capitol  in  Lansing,  January  11, 1887.  The  members  pres- 
ent were  as  follows:  Hon.  John  Avery,  M.  D.,  President;  Prof.  V.  C. 
Vaughan,  M.  D.;  Prof.  Henry  F.  Lyster/M.  D.;  Arthur  Hazlewood,  M.  D.; 
J.  H.  Kellogg,  M.  D.;  and  Henry  B.  Baker,  M.  D.,  Secretary. 

Considerable  business  was  transacted,  and  several  papers  were  presented 
of  public  interest. 

Dr.  Avery,  the  President  of  the  Board,  gave  his  annual  address  at  this 
time  because  this  was  the  last  meeting  before  the  expiration  of  his  term  as 
member  of  the  Board. 

# 

ANNUAL  ADDRESS. 

BY  HON.  JOHN  AVERY,  M.  D.,  PRESIDENT  OF  THE  MICHIGAN  STATE  BOARD 

OF  HEALTH. 

Gentlemen  of  the  Board  : 

It  would  seem  appropriate  that  we  should  pause  at  the  beginning  of  the 
new  year  to  examine  the  work  done  in  the  past,  and  to  forecast,  as  far  as 
possible,  the  duties  of  the  Board  in  the  future. 

It  is  certain  that  the  first  and  highest  duty  of  the  State  is  the  protection 
of  the  health  and  lives  of  its  citizens.  If  health  is  luxury  to  the  rich,  it  is 
the  poor  man's  capital;  and  the  wages  of  each  day’s  work  in  the  interest  of 
that  capital  pays  its  owner.  The  loss  of  a day’s  work  is  a loss  of  interest  on 
invested  capital.  Any  impairment  of  health  is  a loss  of  capital  itself.  Sick- 
ness not  only  impairs  ability  to  labor,  but  it  entails  expenses,  and  thus  both 
stops  interest  and  encroaches  upon  capital.  When  this  impairment  of  health 
is  the  result  of  a preventable  cause,  it  is  evidence  that  a wrong  has  been 
committed  by  some  one. 

, To  prevent  these  wrongs  so  far  as  possible,  and  to  protect  the  health  and 
lives  of  its  citizens,  the  State  has  enacted  public  health  laws,  created  a State 
Board  of  Health,  and  a local  board  of  health  in  every  municipality  in  the 
State.  The  duties  of  these  boards  are  clearly  defined  in  the  laws  creating 
them.  Those  of  the  State  Board  are  supervisory  and  advisory.  It  has  the 
“general  supervision  of  the  interests  of  the  health  and  life  of  the  citizens  of 
the  State.’’  It  has  now  been  in  existence  thirteen  years,  a sufficient  length 
of  time  to  warrant  a brief  review  of  the  work  it  has  done. 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Has  it  steadily  approached  the  object  for  which  it  was  created?  Has  it 
faithfully  endeavored  to  perform  its  duties?  Has  it  met  the  expectations  of 
its  friends  and  won  the  confidence  of  the  people  of  the  State? 

Perhaps  I can  not  better  summarize  the  work  of  the  Board  in  the  past 
than  by  quoting  from  an  article  read  by  me  before  the  sanitary  convention 
held  in  Lansing  last  March:  “ The  State  Board  of  Health  has  earnestly  and 
honestly  endeavored  to  carry  out  every  provision  of  the  law  creating  it.  It 
has  each  year  kept  its  expenditures  within  the  amount  appropriated  for  its 
use,  and  covered  back  into  the  treasury  an  unexpended  balance.  It  has 
prepared,  printed,  and  circulated  among  local  boards  of  health,  health  offi- 
cers, and  the  people,  over  500,000  copies  of  monographs  on  different  sub- 
jects relating  to  public  health;  it  has  collected  records  of  sickness  and  deaths 
in  different  parts  of  the  State  and  given  the  results  back  to  the  whole  peo- 
ple ; it  has  inquired  into  the  causes  of  local  epidemics  and  advised  and  warned 
such  communities  of  their  danger.  It  has  investigated  special  causes  of  sick- 
ness, such  as  poisonous  cheese,  diseased  meats,  adulterated  foods,  and  pol- 
luted water  supplies.  The  members  of  the  Board  have  visited  various  places 
in  the  State  where  nuisances  have  been  reported  to  them  by  aggrieved  citi- 
zens, and  advised  as  to  the  remedy  in  such  cases.  They  have  visited,  at  the 
request  otthe  Board  of  Corrections  and  Charities,  poor-houses  and  jails  in 
different  counties  of  the  State,  called  attention  to  their  defects  and  pointed 
out  how  they  might  be  improved.  They  have  visited  the  prisons  and  other 
State  institutions  at  the  request  of  their  officers  or  boards  of  control,  to 
advise  how  their  condition  could  be  bettered ; and  their  advice  has  generally 
been  kindly  and  courteously  received,  and  often  acted  upon  to  the  improve- 
ment of  such  institutions.  They  have  examined  plans  of  public  buildings 
about  to  be  erected,  and  suggested  alterations  as  to  heating,  ventilation, 
sewerage,  drainage,  plumbing,  and  lighting,  and  safety  in  case  of  fire,  and 
their  suggestions  have  been  kindly  and  thankfully  received  and  acted  upon 
by  architects  and  builders.  And  the  results  of  these  inspections  of  the  plans 
of  public  buildings  is,  not  only  that  the  State  has  buildings  better  adapted 
to  the  uses  for  which  they  are  designed,  but  more  attention  is  being  paid  to 
these  details  in  building  public  halls,  school-houses,  churches,  and  private 
residences,  and  in  this  way  the  comfort,  safety,  and  health  of  the  people  are 
better  cared  for.  They  are  in  direct  and  frequent  communication  with  every 
city,  village  and  township  in  the  State  through  their  local  boards  of  health 
and  health  officers.  They  act  as  a sort  of  central  signal  station  to  which  sig- 
nals of  alarm  and  danger  are  sent  from  every  part  of  the  State  and  from 
which  warning  is  sent  to  the  endangered  and  advice  to  the  afflicted.” 

The  Board  has  maintained  pleasant  and  profitable  relations  with  neighbor- 
ing State  Boards  of  Health,  and  with  the  National  Board  of  Health,  and  its 
work  has  been  approved  and  commended  by  both. 

There  can  be  no  question  but  that  the  practical  exemption  of  the  people 
of  this  State  from  small-pox  during  the  prevalence  of  an  epidemic  in  a 
neighboring  province  that  paralyzed  business  and  claimed  more  than  four 
thousand  victims,  in  1885,  was  due  to  the  efficient  immigrant  inspection  ser- 
vice inaugurated  by  the  Michigan  State  Board  of  Health,  and  afterwards 
continued  by  the  national  health  authorities. 

There  have  been  held  under  the  auspices  of  the  Board  sixteen  sanitary 
conventions  in  as  many  different  localities  in  the  State. 

These  conventions  have  generally  been  well  attended  by  local  health  offi- 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11,  1887. 


3 


■cers,  in  their  immediate  vicinity,  and  by  the  public  generally,  with  the  effect 
of  bringing  the  local  health  officers  and  the  State  Board  into  closer  relations 
with  each  other,  and  of  creating  a morn  general  interest  in  all  matters  per- 
taining to  the  public  health.  The  papers  read  at  these  conventions  and  the 
discussions  elicited  have  been  given  to  the  people. 

While  it  is  true  there  are  at  the  present  time  frequent  outbreaks  of  com- 
municable diseases,  particularly  of  scarlet  fever  and  diphtheria,  it  is  also 
true  that  these  outbreaks  are  generally  confined  to  the  initial  cases,  and 
owing  to  the  better  information  of  the  people  and  more  efficient  action  of 
local  boards  of  health,  these  diseases  are  not  allowed  to  spread  as  in  former 
years. 

This  summary  of  work  accomplished  is  also  a forecast  of  the  work  to  be 
•continued  by  the  Board. 

Continue  the  education  of  the  people  by  means  of  sanitary  conventions 
and  the  circulation  of  printed  matter  upon  all  subjects  pertaining  to  public 
health  work  upon  which  the  public  need  to  be  informed. 

Inaugurate  and  carry  forward  a vigorous  and  uncompromising  campaign 
against  the  ever  present  nuisance  of  the  privy  vault  and  cesspool. 

Devise  some  practical  method  for  the  disposal  of  excreta  and  kitchen  waste 
in  unsewered  cities,  villages  and  the  rural  districts,  that  the  water  supply 
may  not  be  polluted  in  these  localities. 

If  possible,  inaugurate  a system  of  house-to-house  inspection,  in  order 
that  each  municipality  may  be  informed  of  the  sources  of  danger  in  its 
midst. 

Would  it  not  be  in  the  interest  of  public  health  for  the  Board  to  inquire 
into  the  practical  value  of  teaching  the  elements  of  hygiene  in  our  common 
;and  graded  schools? 

Would  it  not  be  of  value  to  the  people  of  the  State,  and  in  the  interest  of 
public  health,  for  the  Board  to  make  suggestions  in  regard  to  the  construc- 
tion, heating,  and  ventilation  of  common  country  school-houses,  and  per- 
haps to  furnish  a few  general  plans  for  the  same? 

And  now,  gentlemen,  fully  impressed  with  the  importance  of  the  work 
accomplished  by  the  Board  in  the  past,  and  with  its  value  to  the  people  of 
the  State,  and  with  a firm  belief  that  its  usefulness  will  increase  with  each 
year’s  added  experience,  it  remains  for  me  to  congratulate  the  Board  that  it 
hae  been  its  good  fortune  to  have  been  at  all  times  so  ably  represented  by  a 
competent  and  efficient  secretary,  and  to  thank  each  individual  member  for 
the  uniform  courtesy  I have  received  from  them  during  the  time  I have  been 
•connected  with  the  Board. 

CONDITION  OF  HEALTH,  LAST  QUARTER  OF  1886. 

In  his  “ Quarterly  report  of  work,”  the  Secretary  said  : “ The  office  during 
the  quarter  has  received  information  of,  and  has  taken  action  relative  to, 
48  outbreaks  of  typhoid  fever  in  Michigan ; 63  outbreaks  of  scarlet  fever, 
and  111  outbreaks  of  diphtheria.  To  such  localities  there  have  been  sent, 
for  distribution  to  the  neighbors  of  those  sick,  about  480  documents  on  the 
prevention  of  typhoid  fever ; about  650  on  the  restriction  and  prevention  of 
scarlet  fewer,  and  about  1,100  on  the  restriction  and  prevention  of  diph- 
theria.” 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


SICKNESS  AND  METEOROLOGICAL  CONDITIONS  IN  THE  FOURTH  QUAR- 
TER OF  1886  COMPARED  WITH  THE  THIRD  QUARTER  OF  1886,  AND 
WITH  THE  AVERAGE  FOURTH  QUARTER  IN  THE  EIGHT  YEARS  1879- 
1886. 

Contagious  Diseases. 

Compared  with  the  preceding  quarter  (July,  August  and  September),  re- 
ports received  from  all  sources  show  the  number  of  places  at  which  diphtheria 
was  reported  to  have  increased  by  an  average  of  sixteen  places  per  month, 
scarlet  fever  to  have  increased  by  an  average  of  fifteen  places  per  month,, 
typhoid  fever  to  have  decreased  by  an  average  of  one  place  per  month,, 
measles  to  have  occurred  at  the  same  ' number  of  places,  and  small-pox  to 
have  decreased  by  an  average  of  one  place  per  month,  in  the  fourth  quarter 
of  1886. 

Sickness  from  all  Causes. 

A comparison  of  meteorological  conditions  of  the  fourth  quarter  of  1886 
with  the  meteorological  conditions  of  the  third  quarter  shows  the  tempera- 
ture to  have  been  much  lower,  the  absolute  humidity  to  have  been  much  less, 
the  relative  humidity  more,  and  the  day  and  the  night  ozone  less  in  the 
fourth  quarter  than  in  the  third  quarter  of  1886. 

Compared  with  the  preceding  quarter  (July,  August  and  September),  the* 
reports  received  from  regular  observers  indicate  a marked  increase  of  influ- 
enza, bronchitis,  tonsilitis,  pneumonia,  neuralgia,  rheumatism,  and  diph- 
theria, and  a marked  decrease  of  diarrhea,  cholera  morbus,  cholera  infan- 
tum, dysentery  and  intermittent  fever  in  the  fourth  quarter  of  1886. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quarter  of 
1886  with  the  average  of  corresponding  quarters  in  the  eight  years,  1879— 
1886,  shows  that  in  1886  the  temperature  was  slightly  lower,  the  absolute 
humidity  was  slightly  less,  the  relative  humidity  and  the  night  ozone  were 
slightly  more,  and  the  day  ozone  was  considerably  more  than  in  the  average 
fourth  quarter  of  the  eight  years,  1879-1886. 

Compared  with  the  average  for  the  corresponding  quarter  in  the  eight, 
years,  1879-1886,  the  reports  received  from  regular  observers  indicate  that, 
intermittent  fever,  remittent  fever,  typho-malarial  fever,  pneumonia,  con- 
sumption of  lungs,  typhoid  fever,  and  diphtheria  were  less  prevalent  in  the 
fourth  quarter  of  1886 ; and  that  there  was  no  disease  that  was  more  than 
usually  prevalent  in  that  quarter. 

EXAMINATION  OF  PLANS  FOR  PUBLIC  BUILDINGS. 

Preambles  and  resolutions  were  adopted  as  follows : 

Whereas,  Relative  to  sec.  7 of  act  206,  laws  of  1881,  (§  418  of  Howell’s  statutes)  which  law  requires 
boards  of  charitable,  penal  and  reformatory  institutions  to  submit  plans  of  proposed  public  build- 
ings to  the  Board  of  Corrections  and  Charities,  and  to  the  State  Board  of  Health,  for  examination 
and  opinion  thereon,— certain  State  institutions  have  fixed  the  time  and  place  for  such  examination 
and  opinion  when  it  was  impossible  for  members  of  this  Board  to  attend,  and  have  then  adopted 
plans  without  submitting  them  to  the  State  Board  of  Health  for  its  opinion ; and, 

Whereas,  The  law  does  not  give  the  boards  of  State  institutions  the  power  to  fix  absolutely  the 
time  for  the  examination,  by  the  State  Board  of  Health,  of  plans  for  proposed  public  buildings ; and 
Whereas,  Because  of  previous  engagements  to  attend  Sanitary  Conventions  or  other  special 
meetings  of  this  Board,  it  is  at  some  times  impracticable  for  this  Board  to  meet  at  short  notice  at  a 
given  time  or  place ; therefore, 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11.  1887. 


5 


Resolved , That  boards  of  control  of  State  institutions  having  plans  to  submit  to  this  Board  under 
«ec.  7 of  act  206,  laws  of  1881,  are  respectfully  requested  to  file  such  plans  in  the  office  of  the  Board  in 
the  State  capitol  at  such  times  as  that  they  may  be  examined  at  one  of  the  regular  meetings  of  this 
Board,  which  meetings  occur  on  the  second  Tuesday  of  each  January,  April,  July,  and  October;  and 
that  when  this  is  impracticable  or  inconvenient,  the  plans  be  filed  and  not  less  than  ten  days’  time 
he  given  this  Board  to  call  a special  meeting  for  the  purpose  of  the  examination  of  such  plans,  at  the 
office  of  the  Board,  at  the  place  of  the  proposed  building,  or  at  the  place  of  some  sanitary  convention, 
as  the  circumstances  may  require. 

Resolved , That  it  will  facilitate  the  work  of  this  Board  in  the  examination  of  such  plans  and  in  the 
forming  of  opinions  thereon  if  boards  submitting  plans  will  have  their  architect,  or  other  represent- 
ative, present  at  the  meeting  of  this  Board,  to  explain  the  plans,  the  proposed  location,  etc. 

Resolved , That  a copy  of  these  resolutions  he  sent  to  all  State  Boards  of  charitable,  penal  and  re- 
formatory institutions  in  this  State. 

PLANS  FOR  MODEL  SCHOOL-HOUSES. 

A committee  of  three  (Drs.  Avery,  Kellogg  and  Hazlewood)  was  appointed 
to  draft  plans  for  model  school-houses,  including  plans  for  ventilation,  sew- 
erage and  drainage,  and  diposal  of  excreta.  The  committee  was  author- 
ized to  employ  an  architect  to  assist  them.  School  boards,  or  those  having 
in  charge  the  erection  of  school  buildings,  are  requested  to  submit  plans. 

ALLEGED  POLLUTION  OF  DETROIT  RIYER. 

There  was  presented  considerable  correspondence  from  health  officers  of 
cities  and  others  on  the  Detroit  river,  below  Detroit,  concerning  the  alleged 
pollution  of  the  river  by  sewage  and  garbage  from  Detroit,  and  sickness 
in  consequence.  This  subject  was  discussed,  and  was  made  the  special  or- 
der for  the  afternoon  session  of  the  next  regular  meeting,  Tuesday,  April  12, 
1887. 

LABORATORY  OF  HYGIENE  AT  THE  UNIVERSITY. 

Dr.  Lyster,  chairman  of  the  committee  appointed  to  confer  with  the 
Regents  of  the  University  relative  to  the  establishment  of  a laboratory  of 
hygiene  at  that  institution,  made  the  following  report : 

Your  committee  met  with  the  Board  of  Regents,  Dec.  7,  1886,  at  the  Uni- 
versity, each  member  of  the  committee  individually  presenting  the  subject 
to  them : — 

Remarks  by  Henry  F.  Lyster,  M.  D. 

Dr.  Lyster,  chairman  of  the  committee,  said  substantially  as  follows : 

Mr.  President  and  Gentlemen  : — We  regard  the  position  of  the  Board  of 
Regents  as  that  of  those  having  in  trust  the  future  prosperity  of  the  University 
of  Michigan  as  well  as  of  its  present  interests,  and  that  the  one  is  a complement 
of  the  other.  The  time  has  come  in  this  commonwealth  when  the  people  are 
not  satisfied  to  be  the  recipients  merely  of  the  original  ideas  and  original 
work  of  eastern  minds  and  to  appropriate  the  work  of  others.  They  recognize 
the  fact  that  the  assimilation  of  the  brainwork  and  handicraft  of  others  does 
not  develop  the  strength  and  power  th’at  belongs  to  those  who  exercise  their 
minds  and  hands  in  labor. 

The  civilization,  enlightenment  and  the  environment  of  the  people  of 
this  State  are  such  that  it  is  perfectly  competent  for  them  to  enter  upon  the 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


department  of  original  research  in  the  several  branches  of  applied  science* 
and  particularly  in  biology  and  all  that  pertains  to  the  preservation  of  the 
public  health  and  the  limitation  of  disease. 

There  is  no  institution  where  these  branches  of  study  should  be  pursued  other 
than  a laboratory  furnished  and  equipped  with  all  necessary  furniture  and 
machinery  now  approved  and  in  use  and  to  which  such  additional  material 
and  supplies  as  required  may  be  added. 

This  laboratory  should  naturally  belong  to  the  State  University  and  have- 
all  the  advantages  of  the  association  with  the  other  departments  of  learning 
and  of  the  library.  In  union  there  is  strength,  and  in  the  association  of 
these  departments  there  will  be  felt  an  influence  in  the  direction  of  scientific 
thought  and  investigation  which  will  redound  to  the  interest  of  the  Uni- 
versity and  of  the  State  at  large. 

The  University  of  Michigan  after  a history  of  50  years,  and  with  over 
1,300  students,  and  after  all  the  good  it  has  done,  and  all  the  credit  and 
honor  it  has  reflected  upon  the  name  of  this  State,  must  develop  at  once  in 
the  department  of  natural  science  if  it  is  proposed  to  keep  it  among  the  lead- 
ing educational  institutions  in  this  country. 

The  University  of  Cambridge,  England,  has  had  a history  of  more  than 
nine  hundred  years,  and  has  now  about  the  same  number  of  students  in 
attendance,  and  is  still  constructing  new  departments  and  new  courses  of 
lectures  to  meet  the  wants  of  the  times,  and  this  is  equally  true  of  the  Uni- 
versity of  Oxford,  and  of  the  universities  of  Berlin,  Vienna,  Strasburg,  and 
of  other  European  cities  and  States,  as  well  as  of  the  University  of  Harvard, 
and  the  Johns  Hopkins  University  in  this  country. 

Now  if  the  members  of  this  Board  of  Regents  of  the  State  University  are 
not  merely  governors  pro  tempore , but  are  in  reality  the  wardens  of  the  State 
in  whom  are  reposed  the  interests  of  its  crowning  educational  institution  in 
trust,  we  ask  as  representatives  of  the  State  Board  of  Health,  after  13  years’- 
study  of  the  public  health  interest,  that  you  ask  from  the  State* legislature 
such  an  appropriation  as  may  be  necessary  to  organize  and  equip  a suitable 
laboratory  of  biology  and  hygiene  which  in  the  opinion  of  the  board  which 
we  represent  is  absolutely  essential  to  the  best  interests  of  the  people  of  this- 
State  for  their  preservation  and  well-being. 

Remarks  by  Victor  C.  Vaughan,  M.  D.,  Ph.  D. 

Dr.  Vaughan  spoke  substantially  as  follows: 

The  degree  to  which  a nation  or  community  has  advanced  in  civilization- 
may  be  measured  by  the  attention  it  gives  to  the  protection  of  the  health 
and  the  prolongation  of  the  lives  of  its  citizens.  In  the  dark  ages  people 
lived  in  filth.,  were  poisoned  by  their  own  excretions,  and  died  by  the  thou- 
sands. Between  March  and  July,  1348,  there  perished  in  Florence  alone- 
more  than  100,000  persons  from  the  black  death.  Geneva  lost  40,000  inhab- 
itants, Naples  60,000,  Venice  70,000,  and  in  the  brief  space  of  four  years 
there  perished  in  the  whole  of  Europe  not  less  than  40,000,000  of  people 
poisoned  by  the  filth  which  they  had  accumulated  about  themselves.  In 
1665  the  same  filth  disease  swept  from  London  more  than  100,000  of  its  popu- 
lation. By  some  attention  to  cleanliness  the  black  death  has  been  quite 
banished  from  Europe;  but  other  filth  diseases  still  prevail  in  both  hemi- 
spheres. In  our  own  State  there  are  reported  on  an  av'erage  500  deaths 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11,  1887. 


annually  from  typhoid  fever.  There  is  reason  to  believe  that  this  is  actually 
about  one-half  the  true  number,  and  we  would  be  safe  in  saying  that  ther?, 
are  1,000  deaths  each  year  in  this  State  from  typhoid  fever  alone,  and  this 
is  much  less  than  it  was  before  the  State  Board  of  Health  began  its  work. 
For  each  death  from  typhoid  fever  there  are  on  an  average  15  persons  sick. 
This  gives  15,000  cases  of  typhoid  fever  per  year  in  this  State,  and  if  sani- 
tary science  was  thoroughly  understood  by  the  people  there  need  not  be  a 
single  case  of  this  disease.  This  may  seem  to  be  a very  strong  statement, 
but  in  one  place  its  truth  has  been  quite  nearly  demonstrated.  From  1852 
to  1859  the  annual  death  rate  from  typhoid  fever  in  Munich  per  10,000 
inhabitants  was  24.2.  After  the  establishment  of  the  famous  hygienic  labor- 
atory at  Munich,  and  as  a result  of  the  investigations  made  at  that  laboratory, 
certain  municipal  sanitary  improvements  have  been  made  and  the  death  rate 
from  typhoid  fever  has  decreased  until  in  1884  it  was  only  1.4  per  10,000. 
In  a population  of  250,000  this  is  an  annual  saving  of  over  500  lives,  and 
more  than  7,500  cases  of  illness  from  this  one  disease  alone.  But  typhoid 
fever  is  not  the  only  preventable  disease.  The  list  is  a long  one,  and  embraces 
such  dreaded  scourges  as  diphtheria,  scarlet  fever  and  cholera.  Can  the  educa- 
tional facilities  of  the  State  be  better  employed  than  in  giving  instructions 
in  methods  of  preserving  the  health  ? The  State  teaches  the  literature  and 
language  of  ancient  Greece;  should  it  not  give  some  attention  to  the  health 
and  lives  of  its  own  citizens  ? It  makes  doctors  who  are  to  cure  disease; 
would  it  not  be  well  to  give  a little  attention  to  the  prevention  of  disease  P 
It  gives  its  students  instruction  in  the  means  of  preventing  disease  among 
the  lower  animals ; shall  it  leave  from  its  curriculum  altogether  the  study  of 
the  prevention  of  diseases  which  afflict  human  life  ? Are  the  lives  of  its  citi- 
zens of  so  little  value  ? 

Nearly  every  civilized  country  is  now  manifesting  great  interest  in  the 
protection  of  the  health  and  prolongation  of  the  lives  of  its  citizens.  Ger- 
many has  established  a number  of  hygienic  institutes  in  connection  with  its 
universities,  and  all  students  are  instructed  in  sanitary  science. 

The  already  famous  Imperial  Laboratory  of  Hygiene  at  Berlin,  under  the 
charge  of  Prof.  Koch,  has  accomplished  a great  work.  Here  the  contagious 
nature  of  consumption  (the  most  dreaded  of  all  diseases  in  this  latitude)  has 
been  demonstrated,  and  the  public  is  how  being  instructed  in  the  methods 
of  procedure  necessary  to  limit  its  spread,  and  the  probabilities  are  that  by 
intelligent  care  in  this  direction  the  death  rate  from  this  disease  will  be 
greatly  decreased. 

France  has  given  much  aid  to  practical  hygiene,  and  the  labors  of  Pasteur 
on  anthrax  and  hydrophobia  are  known  and  appreciated  everywhere. 

The  municipal  laboratory  of  Paris  is  maintained  by  the  city,  and  for  a 
small  fee  anyone  may  have  any  sample  of  food  or  drink  tested  for  adultera- 
tions. In  this  way  the  people  of  Paris  have  become  quite  thoroughly  posted 
concerning  adulterations,  and  from  this  knowledge  the  wisest  and  most 
satisfactory  enactments  against  food  adulterations  have  been  made  and  are 
enforced. 

England  through  its  Local  Government  Board  has  carried  on  many  im- 
portant hygienic  investigations,  among  which  may  be  mentioned  the  recent 
studies  which  have  demonstrated  the  fact  that  scarlet  fever  may  be  transferred 
from  cows  to  children  through  milk. 

In  the  United  States  much  money  has  been  spent  in  health  work.  Several 
States  have  salaried  analysts,  milk  inspectors,  etc. 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


The  Legislature  of  Louisiana  two  years  ago  appropriated  $16,000  to  enable 
Dr.  Holt,  of  the  State  Board  of  Health,  to  make  some  experiments  in  the 
disinfection  of  ships.  As  a result  of  those  experiments,  which  were  success- 
ful, yellow  fever  has  been  practically  kept  out  of  the  State.  The  same  State 
maintains  the  disinfection  of  ships  at  the  mouth  of  the  Mississippi,  and  thus 
protects  not  only  itself  but  the  whole  of  the  Mississippi  Valley.  The  State 
of  Mississippi  appropriates  $45,000  annually  for  health  work. 

The  policy  of  Michigan  in  its  health  work,  as  in  other  departments  of 
State  legislation,  has  been  to  educate  the  people.  The  Michigan  State  Board 
of  Health  is  not  an  executive  body;  its  powers  are  wholly  advisory,  and  it 
has  accomplished  the  great  work  for  which  it  is  universally  given  credit  by 
educational  means;  these  it  hopes  to  strengthen  and  widen  by  the  laboratory 
of  practical  hygiene  which  you  have  been  asked  to  establish. 

There  is  needed  some  place  where  every  health  officer  of  a town,  village  or 
city  can  have  samples  of  drinking  water  or  articles  of  food  tested  for 
impurities  and  adulterations.  This  could  not  be  done  for  nothing,  but  at  a 
minimum  fee,  and  the  money  obtained  for  work  of  this  kind  could  be  turned 
into  the  laboratory  fund ; this  would  give  every  locality  in  the  State  a direct 
interest  in  the  University,  and  all  could  see  the  practical  benefit  to  be 
derived  from  this  department.  Reflexly  this  would  aid  the  University  and 
lead  to  its  more  hearty  support  by  the  people. 

There  are  constantly  being  presented  problems  in  the  study  of  the  origin 
and  spread  of  disease  which  can  be  solved  only  with  the  aid  of  a well- 
equipped  laboratory.  One  or  two  illustrations  will  serve  to  make  this  plain. 
A grocer  sells  to  fifty  people  some  meat  which  is  apparently  all  right,  but  it 
makes  everybody  sick.  What  is  the  cause  of  the  trouble  ? This  can  be 
ascertained  only  by  careful  and  long  study  with  all  the  aid  that  science  can 
bring  to  bear.  The  grocer  can  not  be  expected  to  pay  for  this  investigation 
because  he  is  not  to  blame,  and  certainly  those  poisoned  can  not  be  asked 
to  pay  for  it.  The  State  should  do  the  work,  should  endeavor  to  ascertain 
the  cause  and  instruct  its  citizens  against  future  similar  calamities.  Again 
the  question  of  the  best  method  of  the  disposal  of  garbage  is  one  in  which 
every  householder  in  the  State  is  directly  interested,  and  which  can  be  deter- 
mined only  by  laboratory  experimentation.  The  effects  of  slightly  decom- 
posed milk  and  the  methods  of  detecting  and  preventing  such  decomposition 
are  questions  which  need  solution.  These  and  a hundred  other  problems  are 
of  public  interest  and  can  be  solved  only  by  laboratory  work. 

Then  this  laboratory  should  be  made  an  educational  center  in  hygienic 
subjects.  The  results  of  the  work  done  in  it  should,  through  the  State 
Board  of  Health,  be  made  known  to  the  people. 

There  should  also  be  carried  on  in  such  a laboratary  original  investigations 
concerning  the  causation,  nature,  and  prevention  of  disease.  There  can  be 
no  question  as  to  the  duty  of  the  State  in  protecting  the  lives  of  its  citizens, 
and  no  one  can  deny  the  fact  that  education  in  sanitary  matters  is  one  of  the 
most  powerful  protective  aids  that  can  be  furnished  any  people. 

Again,  the  instruction  offered  by  such  a laboratory  to  its  students  will 
make  them  fit  advisers  in  all  sanitary  matters  to  the  various  communities  in 
which  they  live. 

The  following  is  a proposed  plan  of  study  to  be  followed  in  such  a 
laboratory:  » 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11,  1887. 


9 


SCHEDULE  OF  STUDIES. 

I.  The  Air. — A.  Physical  Studies : (a)  Observations  on  temperatures  and 
the  influence  of  temperature  on  health,  (b)  Determinations  of  air  pressure 
and  the  effects  of  variations  in  air  pressure  upon  diseases  of  the  lungs  and 
heart,  (c)  Determinations  of  air  moisture  and  the  effects  of  climate  as 
affected  by  moisture,  (d)  Determinations  of  ozone  and  a study  of  its  rela- 
tions to  disease,  (e)  Ventilation  of  houses. 

B.  Chemical  Studies : (a)  Analysis  of  air  and  determination  of  carbonic 
acid  gas.  (b)  Study  of  organic  matter  in  the  air  and  its  effect  upon  health, 
(c)  Microscopical  studies  of  the  air. 

II.  The  Soil. — A.  Physical  Studies  of  the  Soil: — (a)  Determination  of 
porosity,  (b)  Determination  of  the  capacity  of  the  soil  for  the  absorption  of 
water,  (c)  Determination  of  moisture,  (d)  Determination  of  temperature. 

B.  Chemical  Examination  of  the  Soil : (a)  Determination  of  organic  mat- 
ter. (b)  Analysis  of  ground  air.  (c)  Analysis  of  ground  water,  (d)  Micro- 
scopical examination  of  soil,  (e)  Diseases  due  to  soil  pollution. 

III.  Water. — (a)  Physical  properties,  (b)  Chemical  analysis,  (c) 
Microscopical  examination,  (d)  Diseases  due  to  impure  water. 

IV.  Foods. — (a)  Nutritive  value  of  foods,  (b)  Economical  value  of 
foods,  (c)  Study  of  individual  foods,  (d)  Analysis  of  foods,  (e)  Detec- 
tion of  adulterations. 

V.  Clothing. — (a)  Physical  properties  of  clothing,  (b)  Chemical  prop- 
erties of  clothing,  (c)  Hygienic  considerations  of  clothing. 

VI.  Healthy  Homes. — (a)  Sanitary  locations,  (b)  Sanitary  properties 
of  building  material,  (c)  Study  of  air,  space  and  ventilation,  (d)  The  size, 
arrangement  and  care  of  rooms,  (e)  Study  of  temperature  and  methods  of 
heating,  (f)  Water  supply,  (g)  Disposal  of  waste. 

VII.  Contagious  Diseases. — (a)  The  nature  and  history  of  contagious 
diseases,  (b)  Study  of  germs,  (c)  Restriction  of  contagious  diseases,  (d) 
Vaccination,  (e)  Disinfectants  and  disinfection. 

VIII.  Original  Investigations. — I may  state  that  the  building  should 
be  about  80x60  feet,  two  stories  high,  and  with  basement.  It  would  require 
furnishings  and  apparatus.  There  would  be  need  for  books  and  periodicals, 
as  the  general  library  is  almost  wholly  wanting  in  books  on  sanitary  sub- 
jects. 

Abstract  of  Remarks  by  Henry  B.  Baker,  M.  D. 

Dr.  Baker  said  he  wished  to  endorse  the  outline  which  had  been  presented 
by  Dr.  Vaughan,  and  to  emphasize  the  necessity  of  laboratory  work  as  an 
aid  in  teaching  sanitary  science.  It  was  generally  understood  that  for  the 
successful  teaching  of  chemistry,  laboratory  work  was  essential,  but  he 
thought  it  was  not  so  well  understood  as  it  should  be,  that  for  successful 
teaching  in  sanitary  science  a well-equipped,  laboratory  is  essential.  He 
hoped  the  Regents  would  ask  the  Legislature  for  means  to  establish  the  lab- 
oratory, not  because  it  has  been  recommended  by  the  State  Board  of  Health, 
but  because  it  is  right,  and  will  make  the  University  more  useful  in  promot- 
ing the  welfare  of  the  people.  The  University  can  do  no  nobler  work.  He 
assumed  that  no  elaborate  argument  was  needed  to  convince  the  Regents  of 
the  University  that  mental  training  in  sanitary  science  was  worthy  to  rank 
higher  than  training  in  any  science  or  art  or  literature.  The  question  should 
not  be,  why  establish  an  effective  system  of  training  in  sanitary  science  ? It 
2 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


should  be,  why  has  this  not  been  done  long  ago  ? But  mankind  had  to  wait 
centuries,  until  many  universities  and  educational  systems  had  grown  old, 
before  the  question  was  raised,  “ What  knowledge  is  of  most  worth  ? ” What 
sort  of  mental  training  is  of  most  benefit  to  mankind  ? He  supposed  that 
all  present  had  read  Herbert  Spencer’s  work  on  education  which  started 
with  that  inquiry,  and  which  laid  down  a few  propositions  which  seemed  so 
true  as  to  require  no  proof.  One  conclusion  was,  “ That  knowledge  is  of 
most  worth  which  tends  directly  to  preserve  life.”  Another  is,  in  effect, 
that  next  in  value  is  knowledge  which  tends  indirectly  to  preserve  life.  And 
compared  with  such  knowledge  and  training  in  such  directions,  much  that 
has  been  taught  in  schools  and  in  universities  must  be  placed  low  in  the  scale 
of  immediate  and  prospective  usefulness. 

The  University  is  charged  with  the  noble  duty  of  training  the  minds  of 
those  who  are  to  become  the  leaders  of  thought  throughout  this  State  and  in 
the  nation.  The  State  cannot  afford  to  have  those  who  are  to  be  the  leaders 
in  thought  throughout  the  State  untrained  in  sanitary  science — ignorant  of 
that  knowledge  which  is  of  most  worth.  He  trusted  that  the  Regents  would 
do  all  in  their  power  to  establish  a laboratory  of  sanitary  science,  and  a sys- 
tem of  instruction  therein,  and  as  rapidly  as  possible  raise  the  system  to  that 
high  plane  to  which  sanitary  science  is  entitled  by  reason  of  its  great  useful- 
ness to  mankind. 

The  report  of  this  committee  was  discussed,  and  the  proposed  laboratory 
and  system  of  instruction  heartily  supported  by  all  present.  In  the  course 
of  the  discussion.  Dr.  Baker  presented  the  following: 

The  highest  education,  and  that  of  most  utility,  is  that  which  best  fits 
one  for  right  living,  in  every  sense — that  which  has  to  do  with  the  preserva- 
tion of  life  and  the  perfection  of  physical  and  mental  health.  To  supply 
this  higher  education,  in  recent  times,  the  several  sciences  have  been  laid 
under  contribution  to  form  a science  of  hygiene,  usually  called  sanitary 
science.  So  long  as  the  State  University  fails  to  supply  this  higher  educa- 
tion which  is  of  most  utility  and  vital  importance  to  the  people  of  this  State, 
or  continues  to  give  it  a place  inferior  to  the  ordinary  sciences,  the  Univer- 
sity cannot  expect  more  than  half-hearted  support  by  those  who  have  at 
heart  the  highest  interests  of  the  people. 

The  State  Board  of  Health  passed  a resolution  asking  the  regents  of  the 
University  to'  consider  the  advisability  of  establishing  a laboratory  of 
hygiene,  in  which  original  investigations  should  be  carried  on,  etc. ; but  it 
was  not  considered  that  this  was  the  only  use  for  a laboratory.  If  it  were, 
the  Board  of  Health  itself  might  more  properly  ask  the  Legislature  to  grant 
it  an  appropriation,  so  it  could  do  what  some  other  government  boards  of 
health  do,  namely:  Have  original  investigations  made  under  its  own  direc- 
tion. The  cause  of  that  disease  which  causes  most  deaths  throughout  the 
world  has  apparently  been  discovered  through  such  investigations  under  the 
direction  of  the  Board  of  Health  in  Germany.  But  this  State  Board  of 
Health  had  also  in  view,  and  its  committee  placed  before  the  regents,  the 
idea  of  the  great  importance  of  such  a laboratory,  for  the  purpose  of  teach- 
ing, in  the  best  manner,  at  the  University  of  Michigan,  “ That  knowledge 
which  is  of  most  worth.” 

In  the  Governor’s  message  it  is  shown  that  the  regents  have  a willingness, 
but  not  a great  desire,  to  advance  in  this  direction.  In  that  case,  it  is  pos- 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11,  1887. 


11 


sible  that  a laboratory  of  hygiene  might  be  more  enthusiastically  supported 
in  connection  with  the  State  Agricultural  College,  in  which  great  attention 
is  given  to  some  of  the  sciences  which  lead  up  to  and  contribute  to  sanitary 
science,  and  at  the  head  of  one  department  of  which  is  Prof.  Kedzie,  an  ex- 
President  of  this  Board  and  of  the  American  Public  Health  Association,  and 
a sanitarian  well  known  in  Michigan  and  elsewhere. 

The  proposition  to  maintain  such  a laboratory  at  the  University,  however, 
has  come  about  because  of  recent  valuable  work  done  in  the  present  imper- 
fect laboratory  at  the  University,  by  Prof.  Vaughan,  who  lectures  on  sani- 
tary science,  in  the  school  of  political  economy,  at  the  University,  and  whose 
original  investigations  into  the  nature  of  the  cause  of  numerous  cases  of 
poisoning  in  this  State  have  resulted  in  learning,  not  only  the  nature  of  that 
cause,  but  probably  also  of  the  cause  of  one  of  the  most  important  diseases 
of  mankind.  Prof.  Vaughan’s  important  researches  are  already  known  and 
acknowledged  throughout  the  civilized  world.  It  is  a mistake,  therefore, 
to  suppose  that  it  is  an  entirely  new  scheme  to  establish  a laboratory  of 
hygiene  at  the  Michigan  University.  It  is  not  an  untried  experiment.  It  is 
a proposition  to  give  proper  room,  opportunity  and  support  to  a laboratory 
which  has  already  made  contributions  of  incalculable  value  for  the  promo- 
tion of  human  welfare;  and  a proposition  to  provide  for  better  instruction 
in  a subject  now  imperfectly  provided  for,  but  which  is  the  most  important 
of  all  subjects  which  receive  attention  at  the  State  University. 

The  following  memorial  was  then  unanimously  adopted  and  signed : 

To  the  Honorable  the  Senate  and  House  of  Representatives  of  the  State  of  Michigan : 

Your  memorialists,  the  members  of  the  State  Board  of  Health,  respectfully  represent  that : 

Whereas,  The  highest  education,  and  that  of  most  use,  is  that  which  best  fits  mankind  for  right 
living,  that  which  tends  directly  to  the  preservation  of  life,  and  to  the  perfection  of  physical  and 
mental  health  and  strength  ; and, 

Whereas,  The  teaching  of  such  “knowledge  of  most  worth”  at  the  University  of  Michigan  is  not 
yet  well  provided  for ; therefore, 

Resolved,  That  we  earnestly  memorialize  your  honorable  bodies  to  take  such  action  as  shall  lead 
to  the  maintenance  of  a well-equipped  laboratory  of  hygiene  at  the  University  of  Michigan,  and  of 
such  instruction  in  sanitary  science  at  that  institution,  as  shall  place  that  subject  on  a plane  not 
inferior  to  that  of  any  other  subject  taught  at  the  University. 

The  secretary  presented  to  the  board  a very  handsome  and  artistic  “ Cer- 
tificate of  Thanks”  (24x30  inches),  which  had  been  awarded  to  the  Michigan 
State  Board  of  Health  by  the  International  Health  Exhibition  of  1884,  in 
London,  England,  for  “services  rendered,”  and  which  was  received  through 
the  Department  of  State  at  Washington. 

PRACTICAL  RESULTS  IN  PREVENTING  AND  RESTRICTING  COMMUNI- 
CABLE DISEASES. 

Dr.  Baker  reported  his  attendance,  and  much  valuable  information  gained 
at  the  annual  meeting  of  the  conference  of  State  and  Provincial  Boards  of 
Health,  at  Toronto,  Ontario,  in  October,  1886.  Most  of  the  States  of  the 
Union  and  the  Provinces  of  the  Dominion  were  represented.  The  program 
called  for  a discussion  of  the  following  proposition  from  Kentucky: 

“ What  have  been  the  actual  practical  results  secured,  outside  of  large  cities  and  towns,  in  pre- 
venting the  spread  of  scarlet  fever,  measles,  diphtheria  and  typhoid  fever,  and  how  is  the  cooperation  „ 
of  the  medical  profession  and  the  general  public  best  secured  in  such  work  ?” 


12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


The  discussion  was  opened  by  Henry  B.  Baker,  M.  D.,  secretary  of  the 
Michigan  State  Board  of  Health,  who,  after  preliminary  remarks,  presented 
the  following : 

The  Michigan  State  Board  of  Health  was  established  in  1873.  Late  in  that 
year  the  board  issued  a circular  to  physicians  stating  the  duties  of  physicians 
and  others  under  the  law  in  dealing  with  “small-pox  and  other  diseases  dan- 
gerous to  the  public  health;”  also  showing  the  relative  danger  to  the  pub- 
lic health  from  the  various  communicable  diseases.  The  circular  showed 
that  scarlet  fever  caused  more  deaths  by  far  than  small-pox,  and  it  was  urged 
that  if  scarlet  fever  was  properly  restricted,  the  deaths  from  that  disease 
might  be  greatly  lessened.  The  circulars  were  distributed  to  the  physicians 
throughout  the  State.  From  that  time  forward  scarlet  fever  in  Michigan 
has  been  treated  by  the  State  Board  of  Health  as  a dangerous  communicable 
disease,  and  at  present  isolation  and  disinfection  are  quite  generally  enforced 
by  local  boards. 

Table  1. — Deaths  from  Scarlet  Fever , reported  to  the  Secretary  of  State,  as  having 
occurred  in  Michigan  during  the  five  years , '1869-7 3,  compared  with  the  eleven  years , 
1874-84;  1873  being  the  year,  in  the  latter  part  of  which,  the  Michigan  State  Board 
of  Health  was  established  and  began  its  work.  Also  a comparison  of  the  three  years 
1874-6,  with  the  eight  years,  1877-84 ; the  Document  on  the  Restriction  and  Preven- 
tion of  Scarlet  Fever  having  been  issued  by  the  State  Board  of  Health  in  1877,  and 
distributed  each  year  since  that  date . 


Years. 

(Five.) 

Deaths. 

Years. 

(Eleven.) 

Deaths. 

Years. 

(Three.) 

Deaths. 

Years. 

(Eight.) 

Deaths. 

1869 

252 

1874 

440 

1874 

440 

1877 

404 

1870 

852 

1§75 

423 

1875 

423 

1878 

429 

1871 

696 

1876 

399 

1876 

399 

1879 

418 

1872 

565 

1877 

404 

1880 

370 

1873 

580 

1878 

429 

1881 

383 

1879 

418 

1882 

592 

1880 

370 

1883 

673 

1881 

383 

1884 

326 

1882 

592 

1883 

673 

1884 

326 

Sums 

2,945 

4,857 

1,262 

3,595 

Averages.. 

589 

442 

421 

449 

I submit  a table  (No.  1)  in  which  the  deaths  from  scarlet  fever  reported 
to  the  Secretary  of  State  as  having  occurred  in  Michigan  during  the  five 
years  (1869-73)  immediately  preceding  the  organization  of  the  State  Board 
of  Health,  is  compared  with  the  eleven  years,  1874-84,  the  period  of  restric- 
tion since  the  Michigan  Board  was  established. 

In  table  1,  I have  also  studied  the  effect  of  the  circulation  of  a document 
giving  detailed  information  relative  to  the  restriction  and  prevention  of 
scarlet  fever.  Such  a document  was  issued  by  the  Michigan  State  Board  of 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11,  1887. 


13 


Health  in  1877,  and  has  been  distributed  thoroughly  each  year  since.  I 
have  compared  the  three  years,  1874-76,  just  before  the  document  was  issued, 
with  the  eight  years,  1877-84,  since  it  was  issued.  Although  the  average 
number  of  deaths  reported  annually  in  the  latter  period  is  slightly  greater 
than  during  the  three  years  immediately  preceding,  partly  because  the  eight- 
year  period  contains  an  epidemic  year,  there  was  not  an  increase  but  a de- 
crease in  the  proportion  of  deaths  to  population.  This  is  shown  in  the  ex- 
hibit (No.  1)  in  which  allowance  is  made  for  the  actual  increase  of  popula- 
tion, and  it  is  found  that  during  the  time  of  the  distribution  of  the  docu- 
ment there  was  a saving  of  64  lives  per  year,  or  512  lives  during  the  eight 
years  compared  with  the  three  years  in  which  the  State  Board  labored  to 
prevent  the  spread  of  scarlet  fever,  but  did  not  distribute  a document  con- 
taining full  directions  how  to  restrict  the  disease.  By  exhibit  1 it  will  be 
seen  that  during  the  entire  period  since  the  organization  of  the  State  Board 
of  Health  the  average  deaths  per  year  were  2.1  per  10,000  inhabitants  less 
than  in  the  period  previous  to  that  time.  The  average  annual  population 
during  the  11-year  period  is  estimated  from  the  population  as  stated  in  the 
Michigan  manual  to  have  been  1,609,023.  This  indicates  a saving  of  338 
lives  per  year,  or  3,718  lives  saved  from  death  from  this  one  disease  during 
the  first  11  years  after  the  State  Board  of  Health  was  established.  (Statis- 
tics for  1885  and  1886  are  not  yet  available.) 

Exhibit  1. — A comparison  of  the  Deaths  from  Scarlet  Fever,  reported  to  the  Secretary 
of  State  as  having  occurred  in  Michigan  during  the  jive  years  (1869-73)  just  preceding 
the  organization  of  the  State  Board  of  Health,  with  the  three  years  (1874-76)  imme- 
diately succeeding  its  organization,  and  those  three  years  (1874-76)  with  the  eight 
years  (1877-84),  durinq  which  the  document  on  Restriction  of  Scarlet  Fever  was  dis- 
tributed; also  the  jive  years  (1869-7 3)  just  before  the  establishment  of  the  Board  with 
the  eight  years  (1877-84)  during  the  use  of  the  document ; and  finally  a comparison 
of  the  jive  years  (1869-73)  just  preceding  the  work  of  the  Board,  with  the  eleven  years 
(1874-84)  since  the  State  Board  of  Health  was  established. 


Periods  of  Time 

Compared. 

Estimated 

Average 

Population. 

Average 
Deaths 
Reported 
per  Year. 

Total 

Reported 

Deaths. 

Average 
Reported 
Deaths  per 
Year  per 
10,000 

Inhabitants. 

Decrease  of 
, Deaths 
per  Year  per 
10,000 

Inhabitants. 

Average  De- 
crease of 
Reported 
Deaths 
per  Year.t 

Lives  Prob- 
ably Saved, 
according 
to  the 
Reports.  *+ 

j 5 years,  1869-73. . . 
13  years,  1874-76... 

1,215,230 

1,384,515 

589 

2,945 

1,262 

4.85 

421 

3.04 

1.81 

252 

756 

J 3 years,  1874r-76. . . 
1 8 years,  1877-84... 

1,384,515 

1,689,988 

421 

1,262 

3,595 

3.04 

449 

2.66 

.38 

64 

512 

(5  years,  1869-73... 

( 8 years,  1877-84. . . 

1,215,220 

1,689,988 

589 

2,945 

3,595 

4.85 

449 

2.66 

2.19 

370 

2,961 

j 5 years,  1869-73... 

1,215,220 

1,609,023 

589 

2,945 

4,857 

4.85 

1 11  years,  1874-84.. 

442 

2.75 

2.10 

338 

3,7i§ 

* Probably  not  all  deaths  were  reported  before  or  since  the  organization  of  the  Board,  consequently 
the  saving  is  probably  greater  than  is  here  shown, 
t Allowing  for  increase  of  population. 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Table  2. — Deaths  from  Small-pox  reported  to  the  Secretary  of  State  as  having  occurred 
in  Michigan  during  the  five  years  1869-73,  compared  with  the  eleven  years  1874r-84  ; 
1873  being  the  year,  in  the  latter  part  of  which  the  Michigan  State  Board  of  Health 
was  established  and  began  its  work.  Also  a comparison  for  the  four  years  1874-77 
with  the  seven  years  1878-84 ; the  Document  ou  the  Restriction  and  Prevention  of 
Small-pox  having  been  issued  by  the  State  Board  of  Health  in  1878,  and  distributed 
each  year  since  that  date. 


Years. 

(Five.) 

Deaths. 

Years. 

(Eleven.) 

Deaths. 

Years. 

(Four.) 

Deaths. 

Years. 

(Seven.) 

Deaths. 

1869 

42 

1874 

18 

1874 

18 

1878 

6 

1870 

9 

1875 

26 

1875 

26 

1879 

6 

1871 

73 

1876 

76 

1876 

76 

1880 

3 

1872 

302 

1877 

102 

1877 

102 

1881 

82 

1873 

90 

1878 

6 

1882 

100 

1879 

6 

1883 

5 

1880 

3 

1884 

3 

1881 

82 

1882 

100 

1883 

5 

1884 

3 

* 

Sums 

516 

427 

222 

205 

Averages.. 

103 

39 

56 

29 

In  table  1 it  is  seen  that  during  the  11  years  of  the  work  of  the  State 
Board  of  Health  the  deaths  from  scarlet  fever,  as  reported  to  the  Secretary 
of  State,  were  reduced  in  the  aggregate  about  one-fourth,  notwithstanding 
the  increase  of  population.  Although  this  is  an  important  reduction,  table 
H shows  that  small-pox  was  reduced  about  two-thirds.  The  greater  success 
in  restricting  small-pox  is  probably  due  to  the  fact  that  for  small-pox  we 
have  the  additional  advantage  of  vaccination  in  preventing  and  modifying 
the  disease. 


ABSTRACT  OF  PROCEEDINGS,  JAN.  11,  1887. 


15 


Exhibit  2. — A comparison  of  the  deaths  from  Small-pox , reported  to  the  Secretary  of 
State  as  having  occurred  in  Michigan  during  the  five  years  ( 1869-73 ) preceding  the 
organization  of  the  State  Board  of  Health,  with  the  four  years  ( 1874-77 ) immediately 
succeeding  its  organization,  and  those  four  years  (1874-77)  with  the  seven  years 
(1878-84)  during  which  the  Document  on  the  Prevention  of  Small-pox  was  distrib- 
uted; also  the  five  years  (1869-73),  just  before  the  Board  was  established,  with  the 
seven  years  (1878-84)  during  the  use  of  the  Document ; and  finally  a comparison  of 
the  five  years  (1869-73)  just  preceding  the  work  of  the  Board,  with  the  eleven  years 
(1874-84)  since  the  State  Board  of  Health  was  established. 


Periods  of  Time 

Compared. 

Estimated 

Average 

Population. 

Average 
Deaths 
Reported 
per  Year. 

Total  Deaths 
Reported. 

Average 
Deaths 
Reported  per 
Year  per 
100,000 
Inhabitants. 

Decrease  of 
Deaths  per 
Year  per 
100,000 
Inhabitants. 

Average  De- 
crease 0. 
Reported 
Deaths 
per  Year.f 

Lives  Saved 
during  the 
Period, 
according 
to  the 
Reports.  *t 

j 5 years,  1869-73... 
14  years,  1874-77... 

1,215,230 

1,409,758 

103 

516 

8.48 

56 

222 

3.97 

4.51 

64 

256 

j 4 years,  1874-77... 
17  years,  1878-84... 

1,409,758 

1,696,034 

56 

222 

3.97 

29 

205 

1.71 

2.26 

38 

268 

J 5 years,  1869-73... 
17  years,  1878-84... 

1,215,220 

1,696,034 

103 

516 

8.48 

29 

205 

1.71 

6.77 

115 

806 

j 5 years,  1869-73... 
1 11  years,  1874-84.. 

1,215,220 

1,609,023 

103 

516 

8.48 

39 

427 

2.42 

6.06 

98 

1,073 

* Probably  not  all  deaths  were  reported  before  or  since  the  organization  of  the  Board,  consequently 
the  saving  is  probably  greater  than  is  here  shown, 
f Allowing  for  increase  of  population. 


In  order  to  ascertain  the  advantage  of  the  distribution  of  the  “ Document 
on  the  Restriction  and  Prevention  of  Small-pox,”  I have  made  in  Exhibit  2, 
a comparison  between  the  periods  of  restriction  without  the  document  and 
the  period  of  restriction  with  the  document;  that  is  a comparison  of  the 
period  1874-77  with  the  period  1878-84.  This  indicates  that  during  the 
time  of  the  circulation  of  that  document  there  was  saved  an  average  of 
thirty-eight  lives  per  annum,  or  268  lives  during  the  seven-year  period.  The 
total  number  of  deaths  from  small-pox  reported  to  the  Secretary  of  State 
during  that  period  was  205,  which  was  31  less  than  half  the  number  which 
would  have  been  reported  if  the  deaths  from  small-pox  had  continued  at  the 
same  rate  as  during  the  four  years  just  preceding  the  distribution  of  the 
document. 

In  exhibit  2 it  may  he  seen  that  during  the  entire  period  since  the  State 
Board  of  Health  has  been  working,  the  average  deaths  from  small-pox  were 
fi.06  per  100,000  inhabitants  less  than  during  the  period  of  five  years  just 
before  the  establishment  of  the  Board.  This  shows  a saving  of  98  lives  per 
year,  or  1,073  lives  saved  during  the  period  of  11  years ; that  is,  there  were 
1,073  less  deaths  from  small-pox  during  this  period  than  there  would  have 
been  had  the  deaths  continued  at  the  same  rate  as  before  the  work  of  the 
Board  commenced. 

Thus,  from  the  two  diseases,  scarlet  fever  and  small-pox,  there  is  indi- 
cated by  the  statistics  in  the  office  of  the  Secretary  of  State  to  have  been  a 
saving  of  nearly  5,000  (4,791)  lives  in  Michigan  during  the  eleven  years  fol- 
lowing the  establishment  of  the  State  Board  of  Health. 


At  this  meeting,  January  11,  1887,  Dr.  Baker  added  comments  as  follows: 


lb 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


The  question  may  arise  whether  some  part  of  the  decline  in  the  mortality 
from  small-pox  and  scarlet  fever,  shown  to  have  occurred  in  Michigan,  may 
not  be  due  to  general  sanitary  progress  rather  than  to  the  measures  of 
prompt  notification,  isolation,  disinfection,  etc.,  under  the  lead  and  direc- 
tion of  the  State  Board  of  Health.  On  this  question  as  good  evidence  appar- 
ently as  is  necessary  is  at  hand.  Wm.  Squire,  M.  D.,  E.  E.  C.  P.,  a promi- 
nent member  of  the  Epidemiological  Society  of  London,  England,  has  lately 
said  : “ Diseases  propagated  by  personal  infection,  such  as  scarlet  fever  and 

small-pox,  have  shown  no  diminution  under  our  extensive  sanitary  works, 
but  require  measures  of  isolation  for  their  control ; they  are  not  checked  by 
the  great  improvements  in  drainage  and  water-supply  that  have  ‘proved  so 
efficacious  against  the  prevalence  of  diarrhoeal  diseases,  and  especially  in 
diminishing  the  amount  of  enteric  fever.  Both  these  points  are  proved  in 
the  reports  of  the  Eegistrar-General.”  * 

Except  in  certain  districts,  the  law  in  England  does  not  require  as  does 
the  law  in  Michigan  that  the  householder  or  physician  shall  promptly  notify 
the  health  officer  on  the  occurrence  of  a dangerous  communicable  disease. 
Sanitarians  in  that  country  have  now  become  convinced  that  those  diseases 
“require  measures  of  isolation  for  their  control”  and  at  the  last  meeting  of 
the  British  Medical  Association,  after  the  discussion  of  a paper  on  the  best 
means  for  the  prevention  of  scarlet  fever,  the  public  health  section  of  the 
association  passed  a resolution  as  follows : 

“That  the  public  health  section,  having  considered  the  paper  read  and  the 
remarks  made,  are  of  opinion  that  the  time  has  arrived  when  the  protection 
afforded  by  the  powers  for  the  compulsory  notification  of  infectious  diseases 
should  be  extended  to  the  population  generally;  and  they  therefore  recom- 
mend the  council  of  the  association  to  consider  at  an  early  date  the  advisa- 
bility of  endeavoring  to  promote  general  legislation  with  this  object  in 
view.”* 

In  England,  therefore,  sanitarians  are  endeavoring  to  establish  those 
methods  for  the  prevention  of  scarlet  fever  which  have  already  been  found 
so  successful  in  Michigan. 

It  should  be  understood,  however,  that  something  more  is  required  than  a 
law  compelling  prompt  notice  of  dangerous  diseases.  In  Michigan  such  a 
law  had  been  passed  many  years  ago,  but  not  the  slightest  attention  had  ever 
been  given  to  it  until  the  State  Board  of  Health  put  life  and  system  into  that 
as  into  other  public  health  work  throughout  the  State. 

It  is  reasonable  to  believe  then  from  the  various  lines  of  evidence,  that 
the  decrease  in  deaths  from  small-pox  and  scarlet  fever  in  Michigan  during 
the  years  when  prompt  notification,  isolation,  and  disinfection  in  these  dis- 
eases have  been  attempted,  has  been  due  to  those  measures.  Especially  does 
it  seem  true  when  we  consider  that  these  communicable  diseases  both  tend 
to  increase  with  increasing  facilities  for  travel  and  rapid  communication 
among  the  people  by  railroad  and  otherwise  as  has  been  the  case  in  Michigan. 

Irrespective  of  the  cause,  however,  the  fact  is  certainly  a gratifying  one, 
that  nearly  five  thousand  (4,791)  persons  in  Michigan  are  yet  alive  who 
would  have  died  from  small-pox  or  scarlet  fever  if  the  deaths  from  those  two 
diseases  had  continued  at  the  same  rate  as  during  the  five  years  just  preced- 
ing the  establishment  of  the  State  Board  of  Health. 


♦British  Medical  Journal,  Oct.  30,  1886,  page  812. 


0 *} 


0*n.  Ub. 


THE  LI3RARY  OF  THE 

JUN  25  1951 


UNWtKSUJf  UF  ILLINOIS 

ABSTRACT  OF  PROCEEDINGS 


OF  THE 

MICHIGAN  STATE  BOARD  OF 


HEALTH. 


REGULAR  MEETING,  JULY  10,  1888. 

[139.] 


The  regular  quarterly  meeting  of  the  Michigan  State  Board  of  Health  was 
held  in  the  State  Capitol  in  Lansing,  July  10,  1888.  The  members  present 
were  as  follows:  Hon.  John  Avery,  M.  D.,  President;  Hon.  C.  V.  Tyler,  M. 
D. ; Arthur  Hazlewood,  M.  D. ; and  Henry  B.  Baker,  M.  D.,  Secretary. 

PROPOSED  HEALTH  LEGISLATION. 

Besides  the  routine  business,  certain  proposed  bills  for  perfecting  the 
Public  Health  Laws  of  the  State  were  discussed  at  the  morning  session  and 
referred  to  the  Committee  on  Legislation.  The  objects  of  the  Bills  are  as 
follows:  — 

1.  A Bill  to  prevent  the  use  and  sale  of  infected  milk  and  infected  milk 
products; 

2.  A Bill  to  declare  the  least  proportion  of  milk  solids  and  of  fat  in  unadul- 
terated milk; 

3.  A Bill  to  require  the  labeling  of  all  gasoline,  benzine  and  naphtha  sold 
at  retail ; and 

4.  A Bill  to  prevent  the  introduction  and  spread  of  dangerous  communica- 
ble diseases. 

Relative  to  Bill  No.  2,  mentioned  above,  it  may  be  said  that  a law  in  Michi- 
gan prohibits  the  sale  of  impure  or  adulterated  milk  (Act  No.  246,  Laws  of 
1887),  and  provides  for  an  inspection  of  milk  in  Detroit  and  other  cities  and 
incorporated  villages  in  the  State.  This  law  provides  penalties  for  its  viola- 
tion, but  it  does  not  fully  explain  what  is  meant  by  pure  milk.  In  each 
prosecution  it  is  necessary  to  go  over  the  whole  ground  of  proving^  what 


2 


MICHIGAN  STATE  BOAlft^DF  HEALTH. 


should  be  taken  as  a standard,  and  why.  If  an  unscrupulous  chemist  appears 
for  the  defense,  and  gives  it  as  his  opinion  that  the  standard  is  too  high,  the 
offending  milkman  may  escape  because  of  this  conflict  of  testimony.  If  the 
law  fixed  a definite  legal  standard,  such  a result  would  not  be  possible.  The 
thousands  of  analyses  made  and  recorded  in  the  different  states  of  the  Union 
supply  a basis  for  fixing  such  a legal  standard.  In  drawing  the  bill  presented 
to  the  Board  at  this  meeting,  the  Secretary  has  corresponded  with  chemists 
and  milk  inspectors  in  other  states,  and  the  bill  is  drawn  in  accordance  with 
the  best  information  which  he  was  able  to  obtain. 

The  object  of  Bill  No.  4,  mentioned  above,  is  to  punish  any  one  who,  know- 
ingly affected  with  small-pox,  scarlet  fever,  diphtheria,  or  any  other  danger- 
ous communicable  disease,  shall  willfully  enter  a public  place  ora  public  con- 
veyance, or  who  shall  willfully  go  into  any  other  locality  without  a permit  of 
the  Board  of  Health  of  that  locality,  or  who  shall  knowingly  and  willfully 
convey  any  child  or  irresponsible  person  affected  with  any  dangerous  com- 
municable disease,  or  the  corpse  of  a person  dead  from  such  disease,  or  who 
shall,  in  any  way,  subject  another  to  danger  of  contracting  one  of  these  dis- 
eases. At  present  there  is  no  statutory  provision  punishing  those  traveling 
from  place  to  place  on  the  cars  or  in  other  public  conveyance,  knowing  them- 
selves to  be  affected  with  a dangerous  communicable  disease,  and  cases  have 
been  brought  to  the  notice  of  the  State  Board  of  Health  which  would  be 
covered  by  this  proposed  bill. 

A letter  was  presented  from  a citizen  of  Branch  county  complaining  that 
incompetent  practitioners  were  driven,  by  the  stringent  laws  of  Indiana  and 
other  states,  into  the  southern  counties  of  Michigan,  and  asking  the  State 
Board  of  Health  to  exert  its  influence  to  protect  the  state  from  charlatans 
and  quacks.  The  subject  was  discussed  by  the  Board  and  referred  to  a com- 
mittee with  instructions  to  draft  a proposed  bill  for  presentation  to  the  legis- 
lature. 

DIETARY  OF  STATE  INSTITUTIONS. 

The  Secretary  stated  that  replies  had  been  received  from  seven  different  State 
Institutions  in  reply  to  the  request  made  by  the  State  Board  of  Health  for 
information  concerning  dietary,  as  follows : — Michigan  State  Prison,  Michi- 
gan School  for  the  Deaf,  Detroit  House  of  Correction,  Michigan  State  Public 
School,  State  Industrial  Home  for  Girls,  Michigan  State  Reform  School,  and 
the  Eastern  Asylum  for  the  Usane.  These  replies  were  read  at  the  meeting 
of  the  Board,  and  were  referred  to  Dr.  Hazlewood  for  further  careful  study 
and  report. 

POISONING  BY  TYROTOXICON. 

A communication  was  read  from  Dr.  Wm.  C.  West,  of  Monroe,  Michigan, 
concerning  about  twenty  cases  of  cheese  poisoning  in  that  city.  Those  poisoned 
“were  taken  at  first  with  great  prostration — a sensation  as  though  they  would 
die.  This  was  followed  by  vomiting,  which  would  relieve  them  somewhat. 
The  vomiting  was  very  severe  in  most  of  the  cases.  The  vomiting  was  followed 
by  diarrhea.  There  was  pain  in  the  stomach  and  bowels.”  AH  who  ate  of  the 
cheese  were  affected. 

A sample  of  the  cheese  was  sent  to  Professor  R.  C.  Kedzie  for  analysis,  and 
the  following  reply  was  received: — 


PROCEEDINGS,  JULY  10,  1888. 


3 


MICHIGAN  AGRICULTURAL  COLLEGE. 

Department  of  Chemistry.  ) 
Ingham  Co.,  Mich.,  June 20,  1888.  $ 

Dr.  H.  B.  Baker,  Sec. , State  Board  of  Health  : 

Dear  Doctor:  The  specimen  of  cheese  you  sent  me  for  examination  of  the  16th  inst. 
has  been  carefully  tested  for  tyrotoxicon.  I find  the  poison  present  in  very  distinct 
quantity.  I have  separated  the  poison  in  needle-shaped  crystals,  usually  associated  in 
stellar  form.  The  reactions  with  ferrocyanide  of  potassium  and  ferric  chloride,  also  with 
iodic  acid  and  starch  are  very  distinctly  given. 

I did  not  try  the  poison  on  the  animal  system,  but  have  no  question  that  the  cheese 
contains  tyrotoxicon,  and  that  its  poisonous  effect  is  to  be  ascribed  to  that  substance. 

Very  truly  yours, 

R.  C.  KEDZIE. 

HEALTH  OFFICERS  SHOULD  ACT  ON  DIAGNOSIS  OF  RELIABLE  PHYSICIAN. 

Complaints  reach  the  State  Board  that  some  health  officers  use  their  offi- 
cial position  to  injure  brother  practitioners  who  report  dangerous  communi- 
cable diseases,  by  going  to  a case  after  the  prominent  symptoms  have  disap- 
peared, deciding  that  it  is  not  the  disease  reported,  and  thus  bringing  upon 
the  physician  who  reported  it  the  contempt  of  the  family.  After  considera- 
ble discussion,  the  following  resolution  was  adopted : 

Resolved,  That  it  is  the  opinion  of  this  State  Board  that  when  a case  of  a 
dangerous  communicable  disease  is  reported  by  a reliable  physician,  the  health 
officer  should  act  upon  the  diagnosis  of  such  physician  without  question. 

COMPENSATION  OF  HEALTH  OFFICERS. 

A postal  card  with  printed  questions  was  sent  to  each  of  1,055  health 
officers  of  townships,  213  health  officers  of  villages,  48  health  officers  of  cit- 
ies (in  all,  1,316  localities)  asking  for  information  concerning  the  compensa- 
tion of  health  officers,  work  performed  by  them,  etc.  Beplies  have  been 
received  from  551  townships,  104  villages  and  20  cities, — in  all  675  localities. 

According  to  the  reports,  provision  is  made  for  an  annual  salary  in  111 
townships,  54  villages  and  18  cities.  The  annual  salaries  provided  for  aver- 
age $16.93  for  each  township,  $128.33  for  each  city,  and  $26.21  for  each 
village. 

In  13  townships  compensation  was  allowed  by  the  day:  in  nine  of  them, 
$2.00;  in  three,  $1.00;  in  one,  $1.50.  (A  general  law,  Act  137  Laws 
of  1883,  provides  for  not  less  than  two  dollars  per  day.)  In  one  town- 
ship it  is  reported  that  the  health  officer  is  paid  75  cents  per  visit. 

Charges  for  services  rendered,  including  salaries,  were  made  in  467  locali- 
ties: an  average  of  $11.60  for  each  of  389  townships;  in  17  cities,  an  average 
of  $137.00  for  each  city  ; and  in  61  villages,  an  average  of  $22.00  for  each 
village.  In  196  localities,  no  charges  were  made  for  services ; and  in  12 
localities,  where  charges  were  made,  the  amount  was  either  not  allowed,  or 
is  in  process  of  settlement. 

Compensation  for  health  officers  was  allowed  and  paid  in  455  localities  as 
follows:  In  376  townships  an  average  for  each  township  of  $11.17;  in  18 
cities  an  average  of  $132.33 ; in  61  villages  an  average  of  $19.19. 

In  response  to  the  question  “How  much,  in  your  judgment,  should  the 
health  officer  in  your  jurisdiction  receive  for  the  full  and  thorough  discharge 
of  his  duties  under  the  law?”  replies  were  received  from  344  townships,  stat- 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


ing  an  average  of  $37  29  for  each  township;  from  19  cities,  estimated 
amounts,  averaging  $331.58  for  each  city;  from  76  villages,  an  average  of 
$81.12  for  each  village. 

From  the  foregoing  statements  it  will  be  seen  that  the  amount  of  compen- 
sation allowed  to  health  officers  for  their  services  during  the  year  1887,  was  for 
health  officers  of  townships, less  than  one-third,  for  health  officers  of  cities,  a 
little  more  than  one-third,  and  for  health  officers  of  villages  not  quite  one- 
fourth,  the  amount  they  consider  a proper  compensation. 

In  reply  to  the  same  question,  relative  to  mode  of  compensation,  72  health 
officers  stated  that  proper  compensation  should  be  a certain  sum  per  day  for 
actual  service, — the  amounts  stated  averaging  $2.19  per  day.  One  said  $3.00 
per  visit,  and  one,  fifty  cents  per  hour.  Forty-six  health  officers  made  replies 
like  the  following:  “According  to  work  performed,”  “according  to  circum- 
stances, ” “ all  he  earns,”  “regular  fees,”  “ same  rate  as  physician,”  etc. 


HOW  WELL  DOES  PUBLIC  OPINION  SUSTAIN  PUBLIC-HEALTH  WORK  P 

A large  majority — 444  of  the  593  health  officers — stated  that  they  were  well 
sustained  ; 151  said  that  they  were  poorly  sustained,  and  36  stated  that  public 
opinion  did  not  sustain  them  at  all. 


SERVICES  RENDERED  BY  THE  HEALTH  OFFICERS. 

Replies  to  the  question  as  to  services  rendered  by  the  health  officer  were 
received  from  593  localities.  The  number  of  nuisances  inspected  in  all  the 
localities  reported  was  5,075;  the  number  abated  was  3,679.  The  number  of 
reports  made  to  the  State  Board  of  Health  was  4,029,  and  the  number  of 
communicable  diseases  looked  after  was  5,389.  The  above  numbers  do  not 
fully  show  the  amount  of  service  performed,  because  many  health  officers 
stated  that  they  had  inspected  and  abated  nuisances,  sent  reports  to  the  State 
Board  of  Health,  and  looked  after  cases  of  communicable  diseases,  but  had 
kept  no  record  in  either  case ; therefore  the  foregoing  numerical  statements 
of  work  performed  are  too  small;  and  they  represent  only  593  out  of  the 
1,494  localities  in  the  State.  It  is  possible  that  the  most  active  and  reliable 
health  officers  made  reports  on  this  subject,  and  if  so  it  would  not  be  safe  to 
assume  that  those  not  heard  from  performed  services  in  the  same  proportion 
as  did  those  who  reported.  However,  the  health  officers  of  some  cities,  who 
make  regular  reports  to  the  State  Board,  failed  to  respond  to  this  circular. 
The  health  officers  of  the  two  largest  cities  in  the  State — Detroit  and  Grand 
Rapids — did  not  respond ; neither  did  the  health  officers  of  the  following 
cities:  Alpena,  Battle  Creek,  Charlotte,  Dowagiac,  Eaton  Rapids,  East  Sagi- 
naw, Escanaba,  Grand  Haven,  Greenville,  Ionia,  Manistee,  Marquette,  Mason, 
Marshall,  Menominee,  Monroe,  Mt.  Clemens,  Muskegon,  Niles,  Owosso, 
Port  Huron,  Saginaw  City,  St.  Clair,  Stanton,  West  Bay  City,  Wyandotte, 
Ypsilanti. 

If  all  the  1,494  health  officers  in  Michigan  performed  services  in  the  same 
proportion  as  did  the  593  who  reported,  then  there  were  over  nine  thousand 
(9,263)  nuisances  abated,  and  over  thirteen  thousand  (13,595)  cases  of  dan- 
gerous communicable  diseases  looked  after  with  the  view  of  restricting  their 
spread  in  Michigan  during  the  year  1887. 


PROCEEDINGS,  JULY  10,  1888. 


5 


EXAMINATION  OF  PLANS  FOR  A PROPOSED  STATE  BUILDING. 

The  plans  for  a proposed  cottage  for  convalescent  insane  near  the  asylum 
at  Kalamazoo  were  examined  at  considerable  length,  but  not  very  satisfactory 
results  could  be  reached  because  of  lack  of  statement  of  details.  Letters 
explanatory  by  the  Medical  Superintendent,  Dr.  Palmer,  were  read  by  the 
Secretary,  andi  these  letters  gave  more  information  than  did  the  plans  them- 
selves. 

The  proposed  cottage  is  to  accommodate  fifty  inmates.  The  plans  and  let- 
ters show  that  considerable  attention  has  been  given  to  some  of  the  sanitary 
requirements.  However  there  were  no  plans  or  specifications  indicating  the 
nature  of  the  plumbing  or  house-drainage ; there  was  no  explanation  of  the 
construction  or  intended  uses  of  the  basement.  The  plans  show  no  ventilation 
of  the  water-closets;  but  a letter  refers  to  a ventilating  pipe  from  each. 
The  details  of  the  plans  were  not  shown  with  such  definiteness  as  would  enable 
the  Board  to  express  an  opinion  on  many  of  the  points  of  proposed  construc- 
tion. This  was  regretted,  especially  as  faulty  construction  and  management 
of  ventilation  and  house-drainage  has  recently  been  alleged  to  have  caused 
serious  outbreaks  of  preventable  disease,  and  deaths,  in  two  State  institutions 
in  Michigan.  The  sizes  of  fresh-air  inlets  are  stated  in  a letter  to  be  four  by 
twelve  inches,  and  the  foul-air  outlets,  four  by  six  inches.  The  Board  sug- 
gested that  they  be  larger,  and  specified  the  area  of  such  inlets  and  outlets 
recommended  for  some  of  the  rooms. 


QUARTERLY  REPORT  OE  WORK  IN  THE  OFFICE  OF  THE  BOARD 
DURING  THE  SECOND  QUARTER  OF  1888. 

The  office  during  the  quarter  has  received  information  of  and  taken  action 
concerning  2?  outbreaks  of  typhoid  fever,  59  outbreaks  of  diphtheria  and  84 
outbreaks  of  scarlet  fever.  To  the  localities  where  these  outbreaks  have  oc- 
curred, the  usual  number  of  documents  on  the  restriction  and  prevention  of 
these  diseases  have  been  sent  for  distribution  to  those  most  interested.  The 
office  ha3  also  received  information  concerning  9L  outbreaks  of  measles. 

Since  the  last  meeting  of  the  Board  the  printing  on  the  Proceedings  of  the 
Sanitary  Convention  at  Traverse  City  has  been  finished,  the  Proceedings  of 
the  Convention  at  Owosso  have  been  printed,  and  the  Proceedings  of  the  Con- 
vention at  Albion  have  been  edited  and  are  in  the  hands  of  the  printer.  June 
5 and  6,  a sanitary  convention  was  held  under  the  auspices  of  the  Board  at 
Manistee.  Members  of  the  Board  were  in  attendance  at  this  Convention. 

The  printed  proceedings  of  the  last  regular  meeting  of  this  Board,  have 
been  sent  to  Sanitary  Journals,  Secretaries  of  State  Boards  of  Health,  and 
other  sanitarians.  Extracts  therefrom  have  appeared  in  numerous  periodi- 
cals. 

The  Annual  Report  of  the  Board  for  1886  has  been  received  from  the 
printer,  and  about  400  copies  have  been  sent  out,  one  copy  in  a place,  by 
mail.  Copies  of  the  supplements  (Sanitary  Conventions  at  Traverse  City, 
and  at  Owosso)  have  also  been  sent  to  sanitarians,  and  to  persons  in  the  places 
where  the  conventions  were  held. 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


A second  demand  has  been  made  on  clerks  of  delinquent  cities,  villages  and 
townships,  for  a return  of  the  name  and  address  of  the  health  officer.  There 
have  been  received,  filed  and  entered  in  the  books,  the  names  of  health  offi- 
cers of  40  cities,  178  villages,  and  1,025  townships.  Documents  explanatory 
of  the  proper  work  of  health  officers  and  of  local  boards  of  health  have  been  i 
sent  to  each  health  officer  whose  name  has  been  returned,  also  to  the  clerk  or 
supervisor  making  the  return. 

A demand  has  been  made  on  new  health  officers  of  cities  and  villages  for 
weekly  card-reports  of  sickness  under  observation. 

The  article  on  meteorology  for  the  Report  of  1887  is  in  the  hands  of  the 
printer,  and  the  article  based  on  weekly  reports  of  diseases  is  ready  to  send 
down  as  soon  as  the  article  on  meteorology  is  printed.  The  facts  concerning 
scarlet  fever  and  typhoid  fever  in  1887  have  been  compiled  for  the  article 
on  communicable  diseases. 

The  summary  of  meteorological  observations  for  each  month  at  this  sta- 
tion has  been  regularly  sent  to  the  chief  signal  officer  at  Washington  and  to 
Sergt.  Conger,  of  the  State  service ; and  the  weekly  and  monthly  summary 
has  been  compiled  and  used  in  comparison  with  weekly  and  monthly  reports 
of  diseases  in  Michigan.  Fifteen  meteorological  tables,  and  their  accom- 
panying diagrams  for  the  year  1887  have  been  completed,  and  the  work  of 
compilation  of  tables  for  1888  has  been  begun. 

The  compilation  of  the  annual  reports  of  health  officers  and  clerks  of 
cities,  villages,  and  townships  for  the  year  1887  has  been  completed  so  far  as 
relates  to  the  communicable  diseases. 

Cards  for  reply  and  copies  of  a circular  letter  asking  information  concerning 
the  compensation  of  health  officers  were  sent  to  all  the  health  officers  of 
townships,  cities  and  villages  in  Michigan,  the  cards  to  be  returned  to  Dr. 
Hazlewood  of  this  Board.  The  cards  received  by  Dr.  Hazlewood  have  been 
forwarded  to  this  office.  Only  675  localities  were  heard  from.  These  cards 
have  been  compiled  and  the  compilation  is  ready  to  be  returned  to  Dr.  Hazle- 
wood for  editing,  and  then  to  be  printed  if  the  Board  deems  it  advisable  to 
do  so.  The  facts  brought  out  by  the  compilation  are  ready  to  be  presented  at 
this  meeting. 

During  the  quarter,  124  books  and  pamphlets  have  been  received  and  placed 
in  the  library  of  the  Board — fifty  of  them  being  periodicals  which  had  been 
previously  received  and  recently  bound  by  the  state  binders. 

During  the  quarter,  637  pages  of  hektograph  work  have  been  executed, 
among  which  was  a circular  informing  a large  number  of  health  officers  of 
the  entrance  into  their  jurisdiction  of  a person  or  persons  who  had  been 
exposed  to  scarlet  fever,  a circular  to'  superintendents  of  State  institutions 
asking  for  bills  of  diet  at  those  institutions,  and  several  proposed  bills  for 
the  prevention  and  spread  of  dangerous  communicable  diseases,  the  adultera- 
tion of  milk  and  milk  products,  and  the  sale  of  certain  explosives  without 
proper  labels, — copies  of  these  billsTeing  thus  submitted  for  criticism  and 
amendment  to  members  of  this  Board  and  other  persons. 

The  reports  from  the  different  State  institutions  relating  to  diet  lists,  when 
received,  were  sent  to  Prof.  Vaughan,  the  committee  of  this  Board  on  foods. 
They  have  been  returned  in  order  to  be  presented  to  this  Board  at  this  meeting. 


PROCEEDINGS,  JULY  10,  1888. 


7 


HEALTH  IN  MICHIGAN  IN  THE  SCCOND  QUARTER  OF  1888. 

Contagious  Diseases. 

Compared  with  the  preceding  quarter  (January,  February  and  March), 
reports  received  from  all  sources  show  the  number  of  places  at  which 
diphtheria  was  reported,  to  have  decreased  by  an  average  of  nineteen  places 
per  month,  scarlet  fever  to  have  decreased  by  an  average  of  two  places  per 
month,  typhoid  fever  to  have  decreased  by  an  average  of  ten  places  per  month, 
and  measles  to  have  decreased  by  an  average  of  fourteen  places  per  month. 
Small-pox  was  reported  at  one  place  in  each  quarter. 

Meteorology,  and  Sickness  from  all  Causes,  Compared  with  the  Preceding 

Quarter. 

A comparison  of  the  meteorological  conditions  of  the  second  quarter  of 
1888,  with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
temperature  to  have  been  much  higher,  the  absolute  humidity  to  have  been 
much  more,  the  relative  humidity  to  have  been  about  the  same,  the  day  ozone 
slightly  less  and  the  night  ozone  slightly  more  in  the  second  quarter. 

Compared  with  the  preceding  quarter  (January,  February,  March),  the  re- 
ports from  regular  observers  show  a marked  increase  of  measles,  and  a marked 
decrease  of  influenza,  pneumonia,  bronchitis  and  neuralgia,  in  the  second 
quarter  of  1888. 

Compared  with  Nine  Years,  187 9-1887. 

A comparison  of  the  meteorological  conditions  of  the  second  quarter  of 
1888,  with  the  average  of  the  corresponding  quarters  in  the  nine  years,  1879- 
1887,  shows  that  in  1888  the  temperature  was  slightly  lower,  the  absolute 
humidity  was  slightly  less,  the  relative  humidity  was  the  same,  and  the  day 
and  night  ozone  considerably  less  in  the  second  quarter  of  1888. 

Compared  with  the  corresponding  quarter  in  the  nine  years,  1879-1887,  the 
reports  received  from  regular  observers  indicate  that  measles  was  more  than 
usually  prevalent,  and  that  intermittent  fever,  remittent  fever,  consumption 
of  the  lungs,  diphtheria,  diarrhea,  and  whooping-cough  were  less  than  usually 
prevalent  in  the  second  quarter  of  1888. 

These  statements  are  for  the  State  of  Michigan  as  a whole ; in  certain  local- 
ities there  has  been  more,  in  other  localities  less  sickness  than  usual. 

Henry  B.  Baker, 

Secretary. 


1 


Ofn.  Ub. 


THE  LIBRARY  OF  THE 

JUN  25  1951 


UNIVERSITY  OF  ILLINOIS 


ABSTRACT  OF  PROCEEDINGS 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


MEETING,  FEB.  7,  1889. 


1144] 

A meeting  of  the  Michigan  State  Board  of  Health  was  held  in  the  State 
Capitol  in  Lansing,  Feb.  7,  1889.  The  members  present  were  as  follows: 
Hon.  John  Avery,  M.  D.,  President;  Prof.  Henry  F.  Lyster,  M.  D. ; J.  H. 
Kellogg,  M.  I).;  Arthur  Hazlewood,  M.  D. ; Prof.  Delos  Fall,  and  Henry  B. 
Baker,  M.  D.,  Secretary. 

At  the  morning  session,  besides  a large  amount  of  routine  business,  such  as 
the  examination  and  auditing  of  bills  and  accounts,  some  proposed  health 
legislation  was  discussed. 

COLD  WEATHER  DISEASES  IN  CHILI. 

In  several  papers  Dr.  Baker  has  pointed  out  the  fact  that  most  of  the  dis- 
eases of  the  lungs  and  air-passages,  and  communicable  diseases  which  enter 
by  way  of  the  air-passages,  increase  after  the  cold  weather,  and  decrease  after 
warm  weather.  In  an  article  on  pneumonia  it  has  been  suggested  that 
one  of  the  most  important  diseases  would  be  lessened  by  securing  the  proper 
warming  and  moistening  of  the  air  breathed  indoors.  At  this  session  of  the 
Board  the  secretary  reported  having  requested  and  received  a communication 
from  Hon.  Clement  Carpenter,  of  Toledo,  Ohio,  ex- Secretary  of  Legation  to 
Chili,  relative  to  his  observations  in  Chili  on  this  subject.  Mr.  Carpenter’s 
communication  was  read,  and  was  found  to  contain  evidence  which  it  would 
be  difficult,  and  perhaps  impossible,  to  obtain  in  this  country.  It  shows 
apparently  great  prevalence  of  all  the  above-mentioned  diseases  under  con- 
ditions the  reverse  of  those  recommended  by  Dr.  Baker  for  their  prevention. 
The  letter  states  that  “ The  winters  in  the  central  and  southern  portion  of 
the  country  being  as  severe  as  with  us,  yet  no  amount  of  argument  could 
persuade  its  people  into  heating  their  houses  after  our  methods,  or  in  fact 
heating  them  at  all.  They  will  bundle  and  wrap  themselves  up  in  heavy 


2 


MICHIGAN  STATE  BO^RD  OF  HEALTH. 

clothing  in  all  manner  of  ways,  Ifet  will  avoid  a fire  as  they  would  a pesti- 
lence.” In  Chili  they  have  a specific  disease  which  they  call  Irae,  brought 
about,  as  is  claimed,  entirely  by  cold  draughts  of  air.  It  is  a kind  of  paralysis, 
affecting  chiefly  the  nose  and  the  muscles  of  the  face,  and  you  meet  many 
people  disfigured  by  it.”  “ There  are  a great  many  deaths  in  Santiago  [capital 
of  the  country]  every  year  from  consumption,  and  from  the  beginning  to  the 
end  of  the  winter  season  diphtheria  and  small-pox  rage  there  with  a violence 
and  intensity,  and  to  an  extent  that  we  know  nothing  about,  and  have  never 
experienced  in  this  country  in  cities  of  like  population.” 

The  entire  communication,  together  with  other  facts  bearing  on  the  sub- 
ject, was  ordered  printed  in  the  annual  report. 

PRECAUTIONS  SHOULD  BE  TAKEN  IN  CASES  OF  MEMBRANOUS  OR  INFLAMMA- 
TORY CROUP. 


At  the  afternoon  session,  after  a good  deal  of  discussion,  the  following 
resolution  was  unanimously  adopted  : 

Whereas,  It  is  often  impossible  to  discriminate  between  cases  of  diphtheria 
and  membranous  or  inflammatory  croup ; and 

Whereas,  Modern  researches  point  to  a probable  common  origin  of  these 
diseases, 

Resolved , That  in  the  opinion  of  this  Board,  membranous  or  inflammatory 
croup  should  be  classed  with  diseases  communicable  and  dangerous  to  the 
public  health,  and  should  be  reported  as  such,  and  the  same  precautions 
should  be  taken  in  cases  of  this  disease,  as  regards  isolation  and  disinfection, 
as  in  cases  recognized  as  diphtheria. 

THE  SMEAD  DRY-CLOSET  SYSTEM  OF  DISPOSAL  OF  EXCRETA. 

The  Secretary  presented  the  following  communication  from  G.  R.  Brandt, 
Principal  of  the  Public  Schools  of  Bancroft,  concerning  the  working  of  the 
Smead  system  for  disposing  of  excreta.  The  communication  is  as  follows: 


Bancroft,  Mich.,  January  26 , 1889. 

H.  B.  Baker , M.  D.,  Laming , Mich.: 

Dear  Sir,— Yours  of  the  25th  inst.,  in  connection  with  reports,  at  hand.  In  compliance  with  your 
request,  I would  report  as  follows  : During  cold  weather,  when  the  air  outside  is  much  colder  than 
that  inside,  the  ventilation  by  means  of  the  Smead  system  is  very  good,  and  no  foul  odors  exist  in 
any  part  of  the  buildiog  during  school  hours,  but  as  soon  as  fires  are  not  kept  burning  in  the 
furnaces,  ventilation  ceases  in  part,  and  the  disagreeable  odors  are  very  noticeable  even  in  the 
school  rooms.  The  tendency  in  this  direction  is  very  much  augmented  when  rainy  weather  exists, 
and  it  is  then  utterly  impossible  to  keep  the  rooms  in  fit  condition  even  when  the  greatest  cire  is 
exercised  by  keeping  a fire  in  the  ventilating  shaft  heater  and  opening  basement  windows.  I find 
also  that  matters  are  becoming  worse  as  the  amount  of  excreta  increases,  and  that  the  foul  air  does 
not  dry  or  remove  the  moisture  from  excreta  to  any  considerable  extent  in  passing  over  the  same. 

Very  respectfully, 


G.  R.  BRANDT. 


The  Secretary  presented  a report  by  Prof.  Vaughan  of  the  examination  and 
analysis  of  water,  sent  by  Dr.  Clapp  of  Mendon,  Michigan,  by  way  of  the 
office  of  the  State  Board  of  Health,  the  water  having  been  suspected  of  caus- 
ing typhoid  fever : 


ABSTRACT  OF  PROCEEDINGS,  Feb.  7,  1889. 


CHEMICAL  ANALYSIS. 


Free  Ammonia 

Albuminoid  Ammonia 

Chlorine - 

Parts  per  Million. 

0.02 

0.21 

34.0 

None. 

Grains 
per  Gal. 

0.0012 

0.012  + 

1.9828 

--  

Nit'rJ,-tftS  --  

None. 

Hardness 

ll.  on  Clark’s  scale. 

No  absolute  standard  for  the  chemical ; 

ourity  of  drinking  water  can  be  given,  but  good  authorities 

agree  on  the  following : 

1. — The  chlorine  ought  not  to  exceed  10  parts  per  million. 

According  to  this  rule  the  above  water  is  very  bad. 

2. — The  Free  Ammonia  ought  not  to  be  more  that  0.05  of  a part. 

There  is  no  excess  of  Free  Ammonia  in  the  Mendon  water. 

3. — If  0.10  part  of  Albuminoid  Ammonia  be  present  the  water  should  be  regarded  as  suspicious,  and 
the  presence  of  0.15  of  a part  or  more  of  this  substance  should  certainly  condemn  the  water. 

As  will  be  seen,  the  Mendon  water  contains  too  much  Albuminoid  Ammonia. 


BACTERIOLOGICAL  EXAMINATION. 


The  water  contains  120  Bacteria  in  each  drop. 

No  pathogenic  germs  were  found,  but  the  putrefactive  micro-organisms  were  identified  : 

A liquefying  bacillus;  a short,  thick  rod  with  rounded  edges. 

2. — Micrococcus  candicans;  this  does  not  liquefy  gelatine. 

3. — A fluorescing  bacillus  : a short  rod  with  rounded  ends,  and  which  does  not  liquefy  gelatine. 
Notwithstanding  the  fact  that  the  typhoid  germ  was  not  found,  the  bad  condition  of  the  water,  as 

shown  by  the  chemical  analysis  and  the  large  number  of  germs  in  it,  should  condemn  its  use  for 
drinking  purposes. 


V.  C.  VAUGHAN,  M.  D., 

» Director  of  the  Michigan  State  Laboratory  of  Hygiene. 

Ann  Arbor,  February  1 , 1889. 


REGISTRATION  OF  PLUMBERS. 


The  following  resolution  presented  by  Dr.  Henry  F.  Lyster,  was,  after 
discussion,  unanimously  adopted: 

Resolved , That  it  is  the  opinion  of  this  Board  that  it  is  desirable  that  all 
persons  engaged  in  the  mechanical  trade  of  plumbing  or  acting  as  plumbers 
should  be  licensed  and  registered,  and  that  their  work  should  be  supervised 
by  inspectors  appointed  by  authority, — this  to  apply  to  all  cities  and  villages 
in  the  State. 

Resolved , That  it  is  advised  that,  when  revisions  of  charters  are  being 
made  by  authorities  of  cities  and  villages,  the  incorporation  of  these  provis- 
ions in  their  respective  charters  be  asked  from  the  State  legislature. 


SANITARY  CONVENTIONS. 


Invitations  to  hold  sanitary  conventions  at  Otsego  and  at  Tecumseh  were 
accepted,  and  the  secretary  was  authorized  to  meet  with  committees  of  citi- 
zens, and  to  perfect  arrangements  for  the  same. 

ARSENICAL  PAPER,  CARD-BOARD,  TOYS  AND  FABRICS. 

The  secretary  exhibited  before  the  Board  a toy  (called  a ‘ ‘Kazoo’’  and 
designed  to  be  put  in  the  mouth)  which  had  caused  sickness  in  Lansing.  The 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


part  which  came  in  contact  with  the  mouth  was  found  to  be  covered  with 
green  arsenical  paper.  The  secretary  stated  that  frequently  boxes  made  of 
arsenical  card -board  were  received  at  the  office.  Poisonous  card-board  is  not 
infrequently  used  for  tickets.  On  motion  of  Dr.  Kellogg,  the  secretary  was 
authorized  to  draft  a bill  to  be  presented  to  the  next  legislature  proposing 
the  prohibition,  under  penalty,  of  the  manufacture  and  sale  of  arsenical 
paper,  card-board,  fabrics,  toys  and  other  articles. 


TYROTOXICON  IN 


CASTERS. 


Dr.  Kellogg  called  attention  to  a recent  case  of  tyrotoxicon  in  oysters.  A 
boy  in  a printing  office  in  Battle  Creek  took  an  oyster  stew  at  a restaurant  at 
11  o’clock  at  night.  The  stew  was  very  slightly  warmed.  In  a few  hours 
he  was  taken  very  sick  with  vomiting  and  purging  and  was  sick  all  the  next 
day.  Dr.  Kellogg  sent  for  some  of  the  oysters  and  obtained  a good  test  for 
tyrotoxicon.  A few  days  afterwards  he  sent  for  some  more  oysters  from  the 
same  restaurant  from  which  also  he  obtained  tyrotoxicon.  He  thought  the 
probable  reason  why  there  were  not  more  frequent  cases  of  poisoning  by  eat- 
ing oysters  was  that  the  tyrotoxicon  was  destroyed  by  heat  in  cooking.  The 
oysters  had  been  received  in  kegs  and  kept  open,  thus  giving  a good  oppor- 
tunity for  the  tyrotoxicon  to  develop. 


SECRETARY’S  QUARTERLY  REPORT  OF  WORK  IN  THE 
OFFICE  OF  THE  BOARD  DURING  THE  QUARTER  ENDING 
JANUARY  8,  1889. 

During  the  quarter  the  office  has  received  information  of  and  taken  action 
concerning  85  outbreaks  of  diphtheria,  77  outbreaks  of  scarlet  fever,  48  out- 
breaks of  typhoid  fever  and  one  of  typhus  fever.  There  have  also  been 
reported  to  the  office  outbreaks  of  small-pox  in  Port  Huron,  East 
Saginaw,  Howell  village,  Howell  township,  New  Haven  township,  Lansing, 
Cheboygan  and  Detroit.  The  office  has  been  in  constant  communication  with 
most  of  these  localities,  and  neighboring  localities,  urging  the  vaccination  of 
all  susceptible  persons  and  the  thorough  isolation  of  all  those  who  could  pos- 
sibly convey  the  disease. 

In  response  to  a letter  asking  the  opinion  of  the  members  of  the  Board,  a 
majority  of  the  members  expressed  the  opinion  that  a letter  should  be  sent  to 
the  Governor  stating  the  facts  concerning  the  existence  of  small-pox  in  other 
States  and  the  probability  of  its  reaching  this  State.  In  accordance  with  this 
expressed  opinion,  November  27,  1888,  a letter  was  sent  to  the  Governor  refer- 
ring to  the  law  passed  in  1885  providing  for  an  inspection  service  to  prevent 
the  introduction  and  spread  of  dangerous  communicable  diseases.  The  1 tter 
stated  that  the  State  Board  of  Health  was  prepared  to  maintain  such  inspec- 
tion “whenever,  in  the  opinion  of  the  Governor,  it  may  be  deemed  necessary.” 
The  letter  indicated  that  the  present  year  was  a year  when  small-pox  might 
be  expected,  gave  the  names  of  States  where  small-pox  at  that  time  prevailed. 


ABSTRACT  OF  PROCEEDINGS,  Feb.  7,  1889. 


5 


called  special  attention  to  the  outbreak  in  Sarnia  and  the  cases  which  had 
occurred  in  East  Saginaw  and  Port  Huron. 

A copy  of  the  letter  to  the  Governor  was  sent  to  each  member  of  this  Board. 

November  14,  a copy  of  the  proceedings  of  the  Board  at  its  October  meet- 
ing was  sent  to  the  health  officer  of  every  city  and  village  in  Michigan,  with  a 
marked  paragraph  giving  the  resolution  of  this  Board  urging  local  boards  to 
recommend  general  vaccination,  and  giving  the  law  authorizing  local  boards 
to  furnish  free  vaccination. 

December  7,  a circular  which  had  received  the  approval  of  the  members  of 
the  board  was  sent  to  the  healtn  officer  of  every  city,  village  and  township  in 
the  State  urging  local  boards  to  recommend  the  vaccination  and  re-vaccina- 
tion of  all  unprotected  persons  in  their  jurisdiction.  Several  letters  were  re- 
ceived in  response  to  this  circular,  stating  that  the  local  Board  of  Health  had 
issued  a notice  urging  general  vaccination,  or  that  free  vaccination  was  being 
offered  to  all,  or  to  those  unable  to  pay  for  it. 

No  response  was  received  from  Grand  Rapids  until  there  was  received  a 
marked  copy  of  the  Grand  Rapids  Democrat  of  December  21,  in  which  the 
health  officer  of  Grand  Rapids  was  reported  as  saying  in  an  interview  that 
there  was  not  any  probability  of  the  Board  of  Health  of  that  city  urging  a 
general  vaccination,  because  the  emergency  had  not  arisen.  In  reply,  the 
Secretary  of  this  Board  sent  a communication  to  the  Grand  Rapids  Democrat 
urging  the  importance  of  the  vaccination  and  re-vaccination  of  all  unpro- 
tected persons.  Some  correspondence  followed  these  communications.  The 
difference  between  the  Grand  Rapids  Board  of  Health  and  the  State  Board 
of  Health  seems  to  be  that  this  board  has  recommended  they? revention  of 
small-pox  by  the  only  known  means,  vaccination  and  re -vaccination,  the 
Grand  Rapids  Board  did  not  propose  to  recommend  this,  but  to  rely  upon 
the  restriction  of  the  disease  after  it -reaches  them. 

December  24,  on  receipt  of  notice  from  Dr.  J.  A.  Wessinger  that  two 
children  of  Oliver  Anderson  (who  was  sick  with  small-pox)  in  Howell, 
Mich.,  had  been  sent  to  Chatham,  Ontario,  a letter  and  telegram  were  at 
once  sent  to  the  health  officer  of  Chatham,  giving  the  information.  In 
reply  a letter  was  received  from  the  town  clerk,  and  also  a copy  of  the 
Banner , published  at  Chatham,  from  which  the  following  quotation  is 
taken : 

“The  telegram  was  a most  kind  and  neighborly  warning,  and  was  promptly  acted  upon. 
Dr.  Hall,  Medical  Health  Officer,  at  once  had  the  family  isolated  at  the  residence  of  their  grand- 
mother, King  street,  east,  and  Chief  Young  has  arranged  for  a continuous  guard  of  the  house 
day  and  night.  The  clothes  of  the  family,  bedding  and  indeed  the  whole  premises  have  been 
fumigated  and  disinfected,  and  the  wearing  apparel  of  the  children  cremated. 

“ There  are  no  indications  of  small-pox  in  the  family,  nor  of  any  disease ; but  the  authorities 
being  aware  that  the  children  were  exposed  to  the  contagion,  act  on  the  principle  of  making 
sure ; and  an  ounce  of  prevention  is  worth  a pound  of  cure  in  such  cases.  A few  days’  careful 
quarantine  will  well  repay  the  work  if  there  is  any  risk  to  be  avoided.  The  Michigan  Board  of 
Health  deserves  the  thanks  of  the  people  of  Chatham  for  their  prompt  warning.” 

About  one  thousand  more  pamphlets  than  are  usually  sent  out  during  a 
quarter  have  been  sent  to  those  localities  where  diphtheria,  scarlet  fever  and 
typhoid  fever  prevailed,  bearing  on  the  restriction  and  prevention  of  these 
diseases.  A large  number  of  pamphlets  on  the  prevention  of  small-pox  have 
also  been  sent  to  those  localities  where  this  disease  has  prevailed. 

The  numerous  outbreaks  of  small-pox  in  Michigan  have  occasioned  con- 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


siderable  correspondence  with  localities  adjoining  or  near  to  infected  locali- 
ties. As  an  illustration  of  such  correspondence,  reference  may  be  made  to  a 
letter  received  from  the  president  of  the  village  council  of  Brighton,  stating 
that  proper  restrictive  measures  were  not  taken  in  the  village  of  Howell.  A 
copy  of  this  letter  was  sent  to  the  members  of  the  board  and  to  the  health 
officer  of  Howell.  In  response,  the  health  officer  of  Howell  visited  the 
office  of  this  board  for  conference,  and  the  Board  of  Health  of  Howell  held 
a meeting  and  on  motion  took  possession  of  a large  square  house  in  the  out- 
skirts of  the  village  for  a hospital. 

In  response,  I was  able  fo  say  to  the  President  of  the  Board  of  Health  of 
Brighton,  that  I had  taken  the  liberty  to  present  the  questions  he  had  asked 
to  the  health  officer  of  Howell,  who  says  that  there  are  four  cases  of  small- 
pox at  Howell — including  two  cases  of  varioloid — and  one  suspected  case ; 
that  all  persons  suspected  of  being  liable  to  communicate  the  disease  are 
isolated,  and  that  efforts  are  being  made  to  find  such  persons.  Ho  one  liable 
to  spread  the  disease  is  allowed  on  the  streets. 

During  the  quarter  94  volumes  and  pamphlets  have  been  received  and 
entered  in  the  library  of  the  Board,  of  which  27  were  by  purchase,  and  67 
were  by  gift  or  exchange. 

Since  the  last  meeting  of  the  Board  there  have  been  1,007  pages  of  hekto- 
graph  work  executed.  Of  these  233  were  notifications  of  and  other  corre- 
spondence relative  to  outbreaks  of  small*pox  in  Port  Huron,  Lansing,  New 
Haven,  Howell  and  Cheboygan;  77  were  circulars  urging  local  boards  to 
encourage  vaccination,  and  the  rest  pertain  to  the  general  work  of  the  Board. 
A hektograph  letter  was  sent  to  some  health  officers  in  Michigan  recom- 
mending that  they  attend  the  meeting  of  the  American  Public  Health  Asso- 
ciation in  Milwaukee. 

The  printed  proceedings  of  the  last  meeting  of  this  Board  have  been  sent 
to  health  officers  of  cities  and  villages,  sanitary  journals,  prominent  sanita- 
rians, etc. 

During  the  quarter  about  twenty-five  hundred  copies  of  the  Report  for 
1887  have  been  distributed.  This  includes  those  sent  to  the  health  officers 
of  cities,  villages  and  townships,  and  to  lists  of  names  supplied  by  members 
of  the  Board.  With  some  of  these  reports  there  was  sent  a supplement  giv- 
ing the  proceedings  of  the  Manistee  Sanitary  convention,  and  other  publica- 
tions. 

December  3 and  4 a profitable  sanitary  convention  was  held  in  Hastings 
under  the  auspices  of  the  Board.  Most  of  the  papers  read  at  this  convention 
are  now  in  the  office  of  the  Board. 

Blanks  and  circular  letters  asking  for  an  an  annual  report  have  been  sent 
to  every  health  officer  in  the  State,  also  to  the  clerk  of  every  local  board  of 
health ; 242  reports  have  been  received  at  this  date  (Jan.  7). 

Proof  has  been  read  on  the  Annual  Report  of  the  Board  for  1888,  all  of 
which  has  now  been  printed  except  the  article  on  the  communicable  diseases, 
which  is  ready  to  print.  The  Report  has  been  indexed  as  fast  as  it  has  been 
printed. 

Three  diagrams  illustrating  an  article  in  the  Annual  Report  for  1888  have 
been  made  and  sent  to  the  engraver.  The  plates  have  been  received. 

A monthly  summary  of  meteorological  conditions  at  this  station  has  been 
regularly  sent  to  the  chief  signal  officer  at  Washington,  a briefer  one  supplied 
to  the  director  of  the  Michigan  Weather  Service,  and  a summary  for  each 


ABSTRACT  OF  PROCEEDINGS,  Feb.  7,  1889. 


7 


Treek  has  been  used  in  connection  with  the  weekly  reports  of  diseases  in 
Michigan. 

Blank  meteorological  registers,  stamped  envelopes,  etc.,  have  been  sent  to 
meteorological  observers  for  their  use  during  the  year  1889. 

Since  the  last  meeting  of  the  Board  compilations  of  meteorological  condi- 
tions for  each  month  in  1888,  except  December,  on  registers  from  nineteen 
stations,  have  been  carried  on  and  are  nearly  completed. 

PRETENTION  OF  SMALL-POX  UNDER  DIFFICULTIES. 

About  election  time  a man  came  from  Fargo,  Dakota,  to  Howell,  Mich., 
sick  with  varioloid.  The*  disease  was  not  recognized  at  first  in  Howell ; but  was 
called  chicken-pox,  therefore  it  spread  somewhat.  The  disease  was  carried 
from  Howell  to  Azalia,  where  again  it  was  not  recognized.  While  it  was 
being  mistaken  for  another  disease  the  president  of  the  local  board  of  health 
was  exposed  to  it  and  was  then  isolated.  The  other  members  of  the  board 
endeavored  to  cope  with  the  disease,  and  a committee  of  citizens  was  appointed 
to  cooperate  with  them  as  a health  committee.  They  were  unable  to  take 
proper  precautions  because  of  lack  of  funds  and  lack  of  confidence  of  the 
people  that  the  bills  would  be  allowed  by  the  Board  of  Supervisors;  and  they 
came  to  Lansing  to  consult  with  the  Secretary  of  this  Bjard  as  to  what  action 
should  be  taken.  The  Secretary  referred  them  to  decisions  of  the  Supreme  Court, 
which  seemed  to  indicate  that  the  Board  of  Supervisors  must  audit  all  claims 
allowed  by  the  local  board.  Members  of  the  committee  stated  that  members 
of  the  Board  of  Supervisors  of  their  county  had  expressed  themselves  as  not 
favorable  to  allowing  such  bills,  and  that  the  committee  knew  of  no  way  of 
obtaining  money  to  cope  with  the  disease,  that  a number  were  sick  and  many 
more  had  fyeen  exposed  and  should  be  isolated.  These  facts  were  laid  before 
the  Governor,  also  the  fact  that  if  the  disease  was  not  stamped  out  in  Azalia, 
it  was  likely  to  spread  to  other  parts  of  the  State,  and  on  this  presentation 
the  Governor  authorized  the  use  of  a small  amount  of  the  appropriation 
under  Act  No.  230,  laws  of  1885,  to  provide  for  the  prevention  of  the  intro- 
duction and  spread  of  cholera  and  other  dangerous  diseases. 

A mistaken  idea  has  been  expressed  that  the  Governor  has  ordered  that 
bills  be  sent  to  the  State  Board  of  Health  for  payment  by  the  State  of  all 
expenses  incurred  in  restricting  small-pox.  There  is  no  such  general  order, 
and  probaoly  will  not  be.  In  this  one  specified  instance  in  which  the  circum- 
stances were  exceptional,  and  there  seemed  to  be  danger  of  the  spread  of  the 
disease  about  the  State,  provision  was  promptly  made  by  the  Governor  to 
prevent  the  spread  of  small-pox.  But  those  peculiar  circumstances  are  not 
likely  to  occur  in  other  localities. 

HEALTH  IN  MICHIGAN  IN  THE  FOURTH  QUARTER  OF  1888. 

Contagious  Diseases. 

Compared  with  the  preceding  quarter  (July,  August  and  September), 
reports  received  from  all  sources  show  diphtheria  to  have  increased  by  an 
average  of  fifteen  places  per  month,  scarlet  fever  to  have  increased  by  an 
average  of  twenty-one  places  per  month,  typhoid  fever  to  have  increased  by 
an  average  of  six  places  per  month,  small-pox  to  have  increased  by  an  average 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


of  four  places  per  month  and  measles  to  have  decreased  by  an  average  or  four 
places  per  month. 

Meteorology , and  Sickness  from  all  Causes , Compared  with  the  Preceding 

Quarter. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quarter  of 
1888,  with  the  meteorological  conditions  of  the  preceding  quarter  shows  the 
temperature  to  have  been  much  lower,  the  absolute  humidity  to  have  been 
much  less,  the  relative  humidity  and  the  night  ozone  to  have  been  more,  and 
the  day  ozone  to  have  been  less  in  the  fourth  quarter  of  1888. 

Compared  with  the  preceding  quarter  (July,  August  and  September),  the 
reports  from  regular  observers  show  a marked  increase  of  tonsilitis,  influenza, 
bronchitis,  rheumatism,  pneumonia  and  typho-malarial  fever,  and  a marked 
decrease  of  diarrhoea,  cholera  morbus,  dysentery,  cholera  infantum  and  con- 
sumption of  the  lungs  in  the  fourth  quarter  of  1888. 

This  Quarter  compared  with  the  Average  for  Nine  Years , 1879-87. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quarter  of 
1888,  with  the  average  of  corresponding  quarters  in  the  nine  years,  1879-1887, 
shows  that  in  1888,  the  temperature  was  slightly  higher,  the  absolute  humid- 
ity was  slightly  less,  the  relative  humidity  was  less,  the  day  ozone*  was  slightly 
more  and  the  night  ozone*  was  about  the  same  in  the  fourth  quarter  of  1888. 

Compared  with  the  average  for  the  corresponding  quarters  of  the  nine 
years,  1879-1887,  the  reports  received  from  regular  observers  indicate  that 
intermittent  fever,  consumption  of  the  lungs,  diphtheria,  remittent  fever  and 
pneumonia  were  less  prevalent,  and  that  there  was  no  disease  more  than 
usually  prevalent  in  the  fourth  quarter  of  1888. 

This  Quarter  Compared  with  the  Average  for  Two  Years,  1886-7. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quarter  of 
1888  with  the  average  of  corresponding  quarters  in  the  two  years,  1886-87, 
shows  that  in  1888  the  temperature  was  slightly  higher,  the  absolute  humid- 
ity was  slightly  more,  the  relative  humidity  and  the  day  and  the  night 
ozone  * were  less  in  the  fourth  quarter  of  1888. 

Compared  with  the  average  for  the  corresponding  quarters  of  the  two 
years,  1886-87,  the  reports  received  from  regular  observers  indicate  that  con- 
sumption, diphtheria  and  pneumonia  were  less  prevalent,  and  that  there  was 
no  disease  much  more  than  usually  prevalent  in  the  fourth  quarter  of  1888. 


(*  Allowance  is  made  for  less  sensitive  test  paper  used  in  1888  than  in  the  preceding  year  (.51  for  the 
day  ozone  and  . 4 2 for  the  night  ozone). 


0*n.  Ub» 


JHE  LI3RASY  OF  THE 

^ ttb*  JUN  25  1951 

UN1VERS1IY  Of  11UWOIS 

ABSTRACT  OF  PROCEEDINGS 


OF  THE 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


& 


REGULAR  MEETING,  APRIL  9,  1889. 


[148] 

The  annual  meeting  of  the  Michigan  State  Board  of  Health  was  held  in 
the  State  Capitol  in  Lansing,  April  9,  1889.  The  members  present  were  as 
follows:  Hon.  John  Avery,  M.  D.,  President;  Arthur  Hazlewood,  M.  D., 
Prof.  V.  C.  Vaughan,  M.  D.,  Prof.  Delos  Fall,  and  Henry  B.  Baker,  M.  D., 
Secretary. 

At  the  morning  session,  besides  routine  business  such  as  the  examination 
and  auditing  of  bills  and  accounts,  Dr.  John  Avery,  President  of  the  Board, 
instead  of  a formal  annual  address,  made  a few  remarks  concerning  the 
increasing  value  of  the  work  of  the  Board  in  collecting  and  spreading  among 
the  people  information  useful  for  the  saving  of  life,  and  concerning  the 
necessity  of  continuing  the  work  of  investigation  and  of  impressing  upon  the 
people  the  facts  already  demonstrated  concerning  the  prevention  and  restric- 
tion of  the  dangerous  communicable  diseases. 

RELATION  OF  FILTH  TO  DISEASE. 

Considerable  attention  was  given  to  a discussion  of  the  influence  of  unsani- 
tary surroundings  in  affecting  the  virulence  of  disease.  After  the  subject 
had  been  very  thoroughly  discussed,  a motion  prevailed  that  Dr.  V.  C. 
Vaughan  be  requested  to  prepare  a paper  presenting  what  evidence  he  could 
procure  on  the  influence  of  filth  on  disease. 

ELECTION  OF  PRESIDENT. 

This  being  the  regular  annual  meeting  and  the  time  for  the  election  of 
President,  Hon.  John  Avery,  M.  D.,  of  Greenville,  was  re-elected  for  the  term 
of  two  years. 

A FATAL  DISEASE  IN  CONCORD  TOWNSHIP. 

A report  by  Prof.  Delos  Fall,  of  a fatal  outbreak  in  Concord  township  was 
presented,  discussed  and  ordered  published  in  the  Annual  Keport. 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


PROPOSED  HEALTH  LEGISLATION. 


The  Secretary  presented  copies  of  the  following  bills,  which,  by  direction 
of  the  Board  at  its  last  meeting,  he  had  transmitted  to  the  health  committee 
of  the  House  of  Representatives: 

A bill,  to  require  the  labeling  of  all  gasoline,  benzine  and  naphtha  sold  at 
retail. 

A bill,  to  prevent  the  introduction  of  dangerous  communicable  diseases  into 
any  township,  city  or  village  in  Michigan,  except  under  specified  regulations. 

A bill,  to  prevent  the  sale  and  use  of  infected  milk  and  milk  products,  by 
prohibiting  the  sale  and  providing  for  the  punishment  of  offenders. 

A bill,  to  prevent  the  spread  of  dangerous  communicable  diseases  by  provid- 
ing for  the  punishment  of  offenders. 

A bill,  to  declare  the  least  proportion  of  milk  solids  and  of  fat  in  unadul- 
terated milk. 

The  Secretary  also  presented  House  bill  No.  671  (File  No.  201),  introduced 
by  Representative  Hanscom,  entitled, — 

A BILL  to  Regulate  the  Practice  of  Medicine,  requiring  certain  Qualifi- 
cations of  persons  beginning  the  Practice  of  Medicine  in  Michigan,  and  the 
Registration  of  all  Practitioners;  repealing  sections  1,  2,  4,  5,  6,  and  7 of 
act  No.  167,  Laws  of  1883,  and  section  2 of  Act  No.  268,  Laws  of  1887,  and 
all  other  acts  or  parts  of  acts  inconsistent  with  this  act. 

If  this  bill  should  become  a law,  those  legally  authorized  to  practice  medi- 
cine at  the  time  it  shall  take  effect  would  be  permitted  to  continue ; but  it 
would  require  that  all  who  subsequently  enter  the  medical  profession  in 
Michigan  shall  have  certain  minimum  qualifications,  as  evidenced  on  exami- 
nation in  the  fundamental  medical  sciences  of  anatomy,  physiology,  and 
pathology,  the  causation  of  disease,  the  chemistry  of  poisons,  sanitary  science 
including  disinfection  and  ventilation,  and  the  English  language.  The 
examining  board  is  to  be  appointed  by  the  Governor  and  Senate,  and  the 
State’s  appointments  are  left  untrammeled  by  any  requirement  that  any 
medical  sect  or  pathy  shall  be  represented ; it  is,  therefore,  in  the  power  of 
the  appointing  power  to  fairly  represent  the  people  of  the  State  of  Michigan, 
not  only  so  far  as  relates  to  the  majority,  or  any  exclusive  system  which  now 
exists,  but  also  any  “new  school”  which  may  hereafter  arise.  This  could 
not  be  if  only  existing  Medical  Societies  were  allowed  to  control.  There  is, 
however,  provision  for  securing  a certain  proportion  of  expert  examiners, — 
each  medical  college  in  Michigan  authorized  by  law  to  confer  the  degree  of 
Doctor  of  Medicine,  or  to  examine  candidates  for  such  degree  to  be  conferred 
by  the  regents  of  the  University,  being  authorized  to  nominate  one  member 
of  the  board  of  examiners,  as  is  also  the  State  Superintendent  of  Public 
Instruction,  and  the  State  Board  of  Health.  On  the  part  of  the  State,  no 
examination  is  permitted  in  subjects  concerning  which  only  opinions  can  be 
expressed.  This  proposed  Jaw  does  not  attack  any  present  or  future  medical 
sect  or  pathy ; it  simply  requires  a little  positive  knowledge.  The  examina- 
tion by  the  State  is  confined  to  questions  of  fact.  “In  the  English  lan- 
guage the  questions  shall  be  restricted  to  established  usage,  and  in  the 
sciences  they  shall  be  restricted  to  established  and  demonstrable  knowledge, 
accepted  as  such  by  those  who  teach  those  sciences.”  The  examining  board 
is  required  to  publish  an  annual  report  which  shall  include  “copies  of 
questions  asked — which  shall  not  all  be  the  same  in  any  two  years,”  so  that 


ABSTRACT  OF  PROCEEDINGS,  April  9,  1889. 


3 


although  the  details  shall  not  be  known  in  advance,  the  nature  of  the  exami- 
nation shall  be  open  to  public  criticism. 

While,  under  the  provisions  of  this  bill,  no  very  high  standard  of  require- 
ments would  be  set  up,  yet  it  must  be  apparent  that  if  its  requirements  were 
enforced  the  tendency  would  be  to  very  greatly  elevate  the  standard  of 
knowledge  among  those  in  whose  care  the  life  of  any  citizen  may  at  any  time 
be  placed,  and  in  whose  care  the  life  of  each  and  every  person  in  the  Scate  is 
likely  to  be  more  than  once  entrusted.  The  movement,  then,  is  in  the  inter- 
ests of  public  health,  and  safety  to  life. 

SANITARY  CONVENTION. 

The  Board  accepted  an  invitation  from  citizens  of  Lapeer  to  hold  a 
sanitary  convention  in  that  place,  and  early  in  September  was  suggested  as 
the  time  for  such  convention. 

CULTURES  OF  DISEASE  GERMS. 

Dr.  V.  C.  Vaughan,  having  with  him  thirty  or  forty  pure  cultures  of  disease 
germs,  was  asked  by  the  Board  to  exhibit  them.  Among  these  cultures  were 
the  following: — the  germ  of  white  pus ; the  lactic  acid  ferment ; Friedlander’s 
butyric  acid  ferment  (the  possible  cause  of  tyrotoxicon) ; Dencke’s  bacillus 
(found  in  cheese  and  resembling  Koch’s  comma  bacillus) ; the  Wurzel  bacillus 
(so  called  because  the  cultures  branch  out  like  roots) ; the  blue  milk  bacillus ; 
Emerich’s  cholera  germ  (sometimes  called  the  Naples  germ,  which  has  since 
been  found  in  the  normal  faeces, — Emerich  has  given  up  the  idea  of  its  being 
the  cause  of  cholera ; it  resembles  somewhat  the  typhoid  germ);  Salmon’s 
germ  of  hog  cholera;  micrococcus  prodigiosus  (the  cause  of  red  bread)  * 
Loeffler’s  diphtheria  germ ; and  the  bacillus  tuberculosis , this  culture  being 
of  especial  interest  because  it  is  the  115th  generation  of  Koch’s  original  cul- 
ture. 

At  the  request  of  the  Board,  Dr.  Vaughan  then  gave  a short  account  of  his 
work  in  Prof.  Koch’s  laboratory  of  hygiene  at  Berlin,  of  Koch’s  lectures  on 
hygiene,  and  Prof.  Frankel’s  lectures  on  bacteriology;  also  of  inoculations 
against  hydrophobia  witnessed  in  Pasteur’s  laboratory  at  Paris. 


SECRETARY’S  QUARTERLY  REPORT  OF  WORK  IN  THE  OFFICE 
OF  THE  BOARD  DURING  THE  QUARTER  ENDING 
APRIL  9,  1889. 

During  the  quarter  the  office  has  received  information  of  and  taken  action 
relative  to  87  outbreaks  of  diphtheria,  131  outbreaks  of  scarlet  fever,  38  out- 
breaks of  typhoid  fever,  and  13  outbreaks  of  small-pox.  The  usual  number 
of  documents  on  the  restriction  of  these  diseases  have  been  sent  to  the  local- 
ities where  these  diseases  prevailed. 

A printed  abstract  of  the  proceedings  of  the  Board  at  its  last  meeting  has 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


been  sent  to  health  officers  of  cities  and  villages,  sanitary  journals,  promi- 
nent sanitarians,  etc. 

A circular  letter  and  blank  for  the  annual  return  of  the  name  and  address 
of  health  officer  have  been  sent  during  the  quarter  to  the  supervisors  of  town- 
ships, the  clerks  of  villages  and  cities  and  to  the  presidents  of  villages  and 
the  mayors  of  cities,  and  replies  are  being  rapidly  received. 

During  the  quarter  there  have  been  sent  out  about  500  copies  of  a circular, 
“Now  is  a Good  Time  to  be  Vaccinated;”  also  about  1,200  copies  of  a pam- 
phlet on  the  restriction  and  prevention  of  small-pox. 

During  the  quarter,  the  Secretary  visited  Otsego  and  Tecumseh  to  make 
arrangements  for  sanitary  conventions  in  those  places.  The  printed  announce- 
ments for  these  conventions  have  been  sent  out. 

During  the  quarter  120  books  and  pamphlets  have  been  received  and  entered 
in  the  library  of  this  Board,  mostly  in  exchange  for  the  publications  of  this 
Board. 

Annual  reports  have  been  received  from  587  health  officers  and  620  clerks 
of  townships,  cities  and  villages.  All  the  cases  and  deaths  from  diphtheria, 
scarlet  fever,  typhoid  fever  and  measles  mentioned  in  these  reports  have  been 
compiled.  All  the  letters  and  reports  received  concerning  the  dangerous 
communicable  diseases  in  Michigan  in  1888  have  been  assorted,  and  the  com- 
pilation of  the  same  has  been  begun. 

Three  hundred  and  eighty-seven  blanks  giving  names  of  medical  prac- 
titioners have  been  received,  arranged  and  filed. 

Proof  has  been  read  on  the  last  part  of  the  Annual  Report  for  1888;  it  has 
been  indexed,  and  copies  should  now  be  ready  for  distribution ; but  are  not 
yet  received  from  the  State  printer. 

The  proceedings  of  the  sanitary  convention  at  Hastings  have  been  edited, 
with  the  exception  of  a few  papers  which  have  not  as  yet  been  received.  The 
copy  has  been  sent  to  the  State  printer. 

Accounts  for  expenses  for  nurse  hire,  etc.,  in  restricting  the  epidemic  of 
small-pox  at  Azalia  to  the  extent  of  four  hundred  dollars  have  been  audited 
and  paid.  The  small  pox  was  stamped  out. 

During  the  quarter,  374  pages  of  hektograph  work  have  been  executed, 
among  which  may  be  mentioned  various  bills  in  the  interest  of  public 
health  sent  to  members  of  this  Board  and  others,  and  finally  presented  to  the 
Legislature. 

A monthly  summary  of  meteorological  conditions  at  this  station  has  been 
regularly  sent  to  the  chief  signal  officer  at  Washington,  a briefer  one  supplied 
to  the  director  of  the  Michigan  Weather  Service,  and  a summary  for  each 
week  has  been  used  in  connection  with  the  weekly  reports  of  diseases  in 
Michigan. 

Compilations  of  meteorological  conditions  for  the  year  1888  at  21  different 
stations  have  been  made  and  are  ready  to  be  tabulated. 

Since  January  1,  1889,  a 7 P.  M.  observation  of  average  temperature, 
absolute  and  relative  humidity,  per  cent  of  clouds,  direction  of  wind,  barom- 
eter and  ozone,  has  been  made  daily  at  the  State  Board  of  Health  office,  and 
by  the  observers  at  Thornville,  Ann  Arbor  and  Kalamazoo.  Since  February  1, 
such  observation  has  been  taken  at  three  other  stations  in  the  State. 

During  the  quarter,  21  diagrams  have  been  made,  illustrating  the  Annual 
Report  for  1889,  the  proceedings  of  the  Sanitary  Convention  at  Hastings,  and 


ABSTRACT  OF  PROCEEDINGS,  April  9,  1889. 


5 


some  statistics  collected  and  compiled  for  Prof.  Vaughan,  relating  to  diseases 
of  infancy. 

The  compilation  of  the  weekly  reports  of  diseases  for  1888,  to  be  printed  in 
the  Annual  Report  for  1889,  is  well  under  way. 

HEALTH  IN  MICHIGAN  IN  THE  FIRST  QUARTER  OF  1889. 

Contagious  Diseases. 

Compared  with  the  preceding  quarter  (October,  November  and  December, 
1888),  reports  received  from  ali  sources  show  diphtheria  to  have  increased  by 
an  average  of  two  places  per  month,  scarlet  fever  to  have  increased  by  an 
average  of  sixteen  places  per  month,  typhoid  fever  to  have  decreased  by  an 
average  of  thirteen  places  per  month,  measles  to  have  increased  by  an  average 
of  two  places  per  month,  and  small-pox  to  have  increased  by  an  average  of  five 
places  per  month. 

Meteorology , and  Sickness  from  all  Causes , Compared  with  the  Preceding 

Quarter . 

A comparison  of  meteorological  conditions  of  the  first  quarter  of  1889 
with  the  meteorological  conditions  of  the  preceding  quarter  shows  the  tem- 
perature to  have  been  considerably  lower,  the  absolute  humidity  to  have  been 
less,  the  relative  humidity  to  have  been  more,  and  the  day  and  the  night 
ozone  to  have  been  slightly  more  in  the  first  quarter  of  1889. 

Compared  with  the  preceding  quarter  (October,  November  and  December, 
1888),  the  reports  from  regular  observers  show  a marked  increase  of  pneu- 
monia, influenza,  tonsilitis  and  bronchitis,  and  a marked  decrease  of  typho- 
malarial,  remittent,  and  intermittent  fevers,  diarrhoea,  dysentery  and  cholera 
morbus  in  the  first  quarter  of  1889. 

This  Quarter  compared  with  the  Average  for  Three  Years , 1886-1888. 

A comparison  of  the  meteorological  conditions  of  the  first  quarter  of  1889 
with  the  average  of  corresponding  quarters  in  the  three  years,  1886-1888, 
shows  that  in  1889  the  temperature  was  higher,  the  absolute  humidity  slightly 
more,  the  relative  humidity  less,  and  the  day  and  the  night  ozone  * were 
slightly  more  in  the  first  quarter  of  1889. 

Compared  with  the  average  for  the  corresponding  quarters  in  the  three 
years,  1886-1888,  the  reports  received  from  regular  observers  indicate  that 
intermittent  fever,  measles,  consumption  of  lungs  and  neuralgia  were  less 
prevalent,  and  that  there  was  no  disease  much  more  than  usually  prevalent 
in  the  first  quarter  of  1889. 

* Allowance  is  made  for  less  sensitive  test  paper  used  in  the  first  quarter  of  1889  than  the  average 
of  that  used  in  the  corresponding  quarters  of  the  preceding  three  years. 


THE  LIBRARY  OF  THE 

C«n.  Ub.  JUN  25  1951 

ABSTRACT  OF  PROCEEDIN®^—  “ 


OF  THE 

♦ . - --  t 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


MEETING  APRIL  15,  1890. 

[158.] 

The  annual  meeting  of  the  Michigan  State  Board  of  Health  was  held  in 
the  State  Capitol  in  Lansing,  April  15,  1890.  The  members  present  were 
as  follows:  Hon.  John  Avery,  M.  D.,  President;  Arthur  Hazlewood,  M. 
D.,  Prof.  Delos  Pall,  and  Henry  B.  Baker,  M.  D.,  Secretary. 

. At  the  morning  session,  besides  routine  business,  such  as  the  examina- 
tion and  auditing  of  bills  and  accounts,  Dr.  Avery  reported  that  the  com- 
mittee had  made  progress  on  the  plans  for  model  school-houses,  and  stated 
that  the  system  of  ventilation  would  be  such  as  the  Board  had  before 
recommended,  with  a separate  foul-air  shaft  for  each  room. 

VENTILATION  OF  SCHOOL-HOUSES. 

. The  Secretary  presented  a communication  from  Albert  McCaleb,  build- 
ing contractor,  Chicago,  concerning  the  heating  and  ventilation  of  school- 
houses  in  accordance  with  the  recommendations  in  the  first  Annual  Report 
of  the  Michigan  State  Board  of  Health.  Selections  from  this  letter  are  as 
follows: 

_ 7 “ Chicago,  III.,  March  15.,  1890. 

Dr.  Baker , Lansing,  Michigan: 

“Dear  Sir:— It  may  be  of  interest  to  you  to  know  that  a system  for 
ventilating  which  embodies  the  construction  proposed  by  Dr.  Kedzie  in 
his  first  report  on  school  hygiene  to  your  board,  in  1873,  has  been  in  suc- 
cessful operation  as  a part  of  the  heating  system  in  a number  of  schools  in 
this  vicinity. 

The  defects  noticed  have  been  just  what  Dr.  Kedzie  mentioned  in  his 
first  reports,  and  those  mentioned  at  various  times  by  your  board  mem- 
bers,  such  as  unequal  ventilation  of  rooms,  especially  those  farthest  from 
^ the  flues,  or  reversal  of  currents  through  the  building  caused  by  adverse 
winds,  foul  weather,  etc.,  thereby  causing  ‘back  drafts,’  and,  when  closets 
were  used,  perceptible  odors  in  school  rooms.  Much  complaint  was  caused, 
but  no  remedy  has  as  yet  been  applied. 

When  new  school  buildings  were  erected  the  boards  investigated  many 
devices,  but  adopted  a method  directly  in  line  with  Dr.  Kedzie’s  recom- 
mendations, combined  with  a system  of  furnace-heating.  Briefly  described, 
the  system  is  as  follows: 

Powerful  furnaces,  filled  with  vertical  air  tubes,  are  placed  in  a ‘ bat- 
f?  ^ v11  a*  cen^ra^  location.  These  are  inclosed  in  brick  in  such  manner 
that  the  air  from  all  mingles  in  a common  head.  This  head,  or  warm  air 
chamber,  is  as  high  as  circumstances  will  permit.  Every  room  requiring 
heat  is  provided  with  a brick  heat  flue,  and  each  flue  is  connected  by  metal 
pipes  to  the  warm  air  chamber. 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


“The  advantages  of  the  ‘battery’  arrangement  are  obvious.  One  fire 
warms  the  w’hole  house  in  mild  weather,  and  no  fuel  is  wasted.  Much 
labor  and  fuel  is  saved. 

“Fresh  air  is  supplied  to  the  battery  by  the  following  arrangement:  A 
large  fresh  air  receiving-room  is  placed  directly  behind  and  connected  to 
the  ‘battery.’  Ducts  of  large  size  supply  this  room  from  all  sides  of  the 
house.  Each  duct  is  fitted  with  automatic  valves  in  such  manner  that 
those  on  the  windward  side  are  always  open,  receiving  a full  supply  of 
fresh  air,  crowded  in  by  whatever  force  the  wind  may  give,  while  those 
valves  on  the  opposite  side  are  closed  by  the  same  force.  A sudden  change 
of  wind  changes  instantly  the  position  of  the  valves  and  no  diminution  of 
supply  is  noticed.  The  tendency  of  the  wind  to  come  through  the  warm 
air  pipes  in  gusts  is  overcome  by  the  elasticity  of  the  air  in  the  cold  air 
receiving  room.  Thus  it  will  be  seen  that  a steady  supply  of  fresh  air  is 
assured. 

“Dr.  Kedzie’s  plan  of  ventilating  is  carried  out,  though  in  a slightly 
modified  manner.  The  large  flue  recommended  by  him,  divided  by  parti- 
tions into  a number  of  smaller  flues,  is  expensive  and  not  always  practica- 
ble. It  has  been  found  much  cheaper,  and  the  results  have  been  better, 
to  build  in  the  partition  walls  a ventilating  flue  for  each  room.  These 
flues  are  placed  side  by  side  with  heat  and  smoke  flues,  in  such  manner 
that  some  heat  is  imparted  to  assist  the  ventilation. 

“As  a matter  of  economy  and  to  save  space,  it  is  customary  to  stop  off 
the  heat-flues  for  first  floor  rooms,  then  continuing  on  and  using  the  same 
flues  to  ventilate  the  second  story  rooms. 

“The  floors  of  each  room  are  furred  up  from  the  joists  by  two  strips, 
making  the  air  space  continuous.  The  spaces  around  the  circumference  of 
each  room  are  stopped  off  with  mortar  .and  boards,  with  the  result  that  the 
space  under  the  floor  of  each  room  is  an  air-tight  box.  Air  can  enter  it 
from  no  source  whatever,  except  from  the  room  to  be  ventilated.  The  air 
from  the  room  is  permitted  to  enter  this  space  through  grated  openings 
placed  at  intervals  in  the  room,  and  thence  passes  into  the  flue  through  a 
large  opening  provided  below  the  floor. 

“If  summer  ventilation  is  desired  by  means  of  the  flue,  a small  gas  01 
oil  heater  is  placed  in  each  flue  to  accelerate  the  current. 

“The  result  in  every  case  has  been  that  the  ventilation  is  equal  and 
reliable  and  not  affected  by  outside  influences. 

“ Reverse  currents  or  regurgitation  of  air  from  one  room  to  another  is 
impossible.  As  the  air  is  carried  through  the  shortest  possible  path,  nc 
motive  power  is  wasted  in  overcoming  friction,  as  in  the  Smead  system. 
By  isolating  each  room,  a ‘slow-burning’  construction  is  obtained.. 

* * * “The  heating  and  ventilating  system  without  closets  is  in  use 

in  Marshall,  Minn.,  Madison,  Wis.,  Racine  and  Beloit,  Wis. 

* * * “I  inclose  plan  of  Duncan  avenue  school,  Hyde  Park,  to  illus- 

trate the  foregoing  description. 

“ I have  erected  school  buildings  in  which  the  Ruttan  system  is  used 
and  am  now  erecting  two  buildings  with  the  above  system  of  independen 
ventilation  embodied.  One  of  the  boards  fo^  whom  I am  now  buildim 
had  intended  to  use  the  Ruttan,  and  drew  their  plans  accordingly,  bu 
upon  investigation  quickly  changed  and  adopted  the  system  abov( 
described. 

“Respectfully, 

“Albert  McCaleb, 

“ Building  Contractor 


ABSTRACT  OF  PROCEEDINGS  APRIL  15,  1890. 


3 


THE  RESTRICTION  OF  MEASLES. 

The  question  is  frequently  asked  the  office  of  the  State  Board  of  Health : 
Should  measles  be  restricted  in  the  same  manner  as  other  dangerous  com- 
municable diseases? 

At  this  meeting  of  the  board  the  Secretary  presented  facts,  opinions  and 
statistics  in  Michigan  and  elsewhere  bearing  on  the  questions:  At  what 
age  is  measles  most  severe?  and  At  what  period  of  the  disease  is  measles 
most  communicable?  Some  of  this  evidence  is  as  follows: 

TABLE  1. — Exhibiting  the  number  of  Deaths  from  Measles  in  persons  under  five  years  of  age  and  in  each 
year  under  five , together  with  the  total  number  of  Deaths  from  Measles  in  persons  of  all  ages  in  the 
United  States  for  the  three , and  for  each  of  the  three  census  years.  ( Compiled  from  the  Eighth , Ninth 
and  Tenth  Censuses  of  the  United  States.) 


Years. 

All  Ages. 

Under  1. 

1 to  2. 

2 to  3. 

3 to  4. 

4 to  5. 

Under  5. 

1860 

3,899 

760 

884 

646 

332 

188 

2,810 

1870 

9,237 

1,871 

2 222 

1,257 

728 

387 

6,465 

1880+ 

8,072 

2,008 

* 1,621 

982 

534 

338 

5,483 

Sum 

21,208 

4,639 

4,727 

2,885 

1,594 

913 

14,758 

Average  . _ _ . . 

7,069 

1,546 

1,576 

962 

531 

304 

4,919 

3,122* 

*Over  half  of  all  deaths  occur  in  children  under  two  years  of  age,  and  the  numbers  average  greatest  in 
the  second  year. 

fThe  numbers  in  this  line  except  under  “All  Ages,”  are  computed  from  the  “Deaths  in  Each  One 
Thousand  Deaths  At  Known  Ages,  Classified  by  Age,  Sex  and  Cause.”  Tenth  U.  S-  Census  (1880)  Vol.  XII, 
Mortality  and  Vital  Statistics,  Part  II,  Table  XVI,  p.  366. 


TABLE  2— Exhibiting,  relative  to  96  outbreaks,  927  cases  of  Measles,  in  Michigan,  in  1887 , the  number  of 
Cases  and  Deaths,  and  the  Per  Cent  of  Deaths  to  Cases  in  each  ten-year  Period  of  Age. 


Of  All  (Nine-six)  Outbreaks. 

Of  All 
Out- 
breaks. 
Total. 

Reported  Cases  and  Deaths— by  Periods  of  Age. 

Under  10. 

10  to  20. 

20  to  30. 

30  to  40. 

40  to  50. 

50  and  over. 

GO 

I 

o 

Deaths. 

Cases. 

Deaths. 

go" 

CD 

£ 

o 

Deaths. 

Cases. 

Deaths. 

Cases. 

Deaths. 

CD 

CO 

a 

O 

Deaths. 

Cases. 

Deaths. 

Total  cases  and  deaths  at  each  period- 

927 

23 

545 

18 

268 

0 

90 

1 

15 

2 

5 

1 

4 

1 

Per  cent  of  deaths  to  cases 

2.5* 

3.3 

0 

1.1 

13.3 

20 

25 

TABLE  3.— Exhibiting,  relative  to  2,484  ( all  in  which  the  ages  were  reported)  cases  of  Measles  in  Michigan 
in  1888 , the  number  of  Cases , and  Deaths,  and  the  Per  Cent  which  the  Deaths  were  of  the  Cases  in  several 
periods  of  ages. 


Reported  Cases  and  Deaths  within  Certain  Ages. 

AH 

Ages. 

Under 
10  yrs. 

10 

to 

20. 

20 

to 

30. 

30 

to 

40. 

40 

to 

50. 

50 

and 

over. 

Number  of  Cases. 

Number  of  Deaths.. 

• 2.484 
48 

1,303 

34 

842 

7 

216 

3 

86 

2 

28 

2 

9 

0 

Per  Cent  the  Deaths  were  of  the  Cases 

*1.9 

2.6 

0.8 

1.4 

2.3 

7.1 

0 

*The  per  cent  which  the  deaths  are  of  the  cases,  as  here  given,  relates  only  to  those  cases  for  which  the 
age  of  the  patient  was  stated  in  the  report. 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


From  tables  1,  2 and  3 it  appears  that  between  the  ages  of  ten  and  twenty 
years  the  deaths  from  measles  are  but  a very  slight  per  cent  of  the  cases, 
being,  in  fact,  in  the  year  1887,  zero,  and  in  the  year  1888 . only  eight- 
tenths  of  one  per  cent.  Possibly,  if  the  statistics  were  compiled  for  five- 
year  periods  instead  of  ten-year  periods,  the  result  might  be  different. 
The  question  arises  whether,  if  children  were  carefully  protected  from  this 
disease  until  this  favorable  age  were  reached,  and  were  then  permitted  to 
have  the  disease  in  isolation  hospitals  (or  otherwise  subjected  to  proper 
isolation),  the  deaths  from  this  disease  would  not  be  reduced  to  a minimum, 
and  the  sickness  as  mild  or  milder  than  that  produced  by  vaccination. 

This  experience  in  Michigan  is  similar  to  the  expressed  opinion  of  med- 
ical writers.  William  Squire  in  Quain’s  Medical  Dictionary,  states:  “With 
us  more  than  half  of  the  whole  number  of  deaths  from  measles  are  of 
children  under  two  years  of  age.” 

To  quote  from  Thomas:  “The  age  of  the  patients  is,  under  all  condi- 
tions, of  the  greatest  influence  upon  the  mortality  of  measles.  Disregard- 
ing the  fact  that  healthy  and  very  young  children  (up  to  about  the  age  of 
six  months)  probably  from  their  feebler  predisposition,  are  attacked  very 
mildly  if  at  all,  the  rule  may  be  laid  down  that  measles  is  essentially 
dangerous  only  for  young  or  very  young  children;  that  its  danger  decreases 
rapidly  with  the  accession  of  years,  and  in  the  late  years  of  childhood  is 
already  at  a minimum;  in  old  people  who  have,  however,  but  little  predis- 
position and  are  rarely  attacked,  the  disease  is  again  dangerous.  Excep- 
tions to  this  are  not  often  reported.” 

The  Time  When  Measles  is  Most  Contagious. 

William  Squire  (Quain’s  Medical  Dictionary):  “The  catarrhal  stage, 
infectious  throughout,  is  often  mistaken  for  a common  cold,  and  no  timely 
separation  is  attempted.  The  cough  is  an  important  means  of  conveying 
the  infection  at  this  time.  * * * Infection  begins  before  the  rash 

appears,  and  the  contagium  may  be  given  off  by  the  third  day,  most  proba- 
bly during  the  greater  part  of  the  incubation  period.  The  contagious  prin- 
ciple, developed  only  in  the  bodies  of  the  sick,  is  found  during  the  height 
of  the  disease  in  the  tissues,  the  secretions,  the  blood  and  the  breath.” 
“ After  an  attack  of  measles  personal  infection  is  probably  over  by  the  end 
of  a month;  it  may  persist  longer,  or  be  conveyed  somehow  by  convales- 
cents for  another  month.  How  long  infection  may  cling  to  articles  of 
clothing,  or  linger  in  closed  rooms,  is  uncertain.”  On  the  fourth  day  of  the 
initial  fever  the  eruption  appears  and  continues  four  days. 

Wood’s  Reference  Hand  book  states:  “Although  the  nature  of  the 
disease  may  be  conjectured  during  the  prodromal  stage,  it  is  only  during 
the  eruptive  stage  that  the  diagnosis  of  measles  can  be  definitely  deter- 
mined.” “ The  danger  of  contagion  is  proportionate  to  the  propinquity  of 
the  contaminating  influence,  being  greatest  in  the  sick  room.  It  can  not 
be  denied  that  measles  may  be  spread  by  mediate  contagion.  In  such 
cases  the  clothing  probably  becomes  the  disseminating  agent.  * * * 

Except  small-pox  measles  is  probably  the  most  contagious  of  the  exan- 
themata and  is  communicable  from  the  early  prodromal  stage  until 
desquamation  is  completed.  The  infectious  properties  are  probably  most 
active  during  the  prodromal  stage.  The  great  difficulty  of  identifying 
measles  during  this  stage  in  great  measure  explains  the  rapid  dissemination 
of  the  disease  in  schools,  asylums,  etc.  The  contagious  properties  continue 


ABSTRACT  OF  PROCEEDINGS  APRIL  15,  1890.  5 

throughout  the  stage  of  eruption,  but  speedily  diminish  with  it  and  proba- 
bly become  extinct  during  desquamation.” 

I.  N.  Brainerd,  M.  D.,  of  Alma,  Michigan,  in  a letter  to  this  office  bear- 
ing on  this  subject,  dated  March  8,  1890,  states: 

“Dr.  Hardaway,  Professor  of  diseases  of  the  skin  in  the  St.  Louis  Post- 
graduate School  of  Medicine  and  in  the  Missouri  Medical  College,  St. 
Louis,  and  President  of  the  American  Dermatological  Association,  says: 
‘Various  circumstances  render  it  probable  that  measles  is  most  readily 
propagated  during  the  stage  of  efflorescence.’ — Pepper's  System  of  Medi- 
cine, Vol.  I .,  page  560.  This  being  the  case,  the  most  infectious  stage  of 
the  disease  is  not  passed  before  the  disease  can  be  recognized  and  notice 
of  its  presence  be  given.  It  is  true  that  measles  is  communicable  during 
the  four  days  of  prodromal  fever,  during  the  five  days  of  efflorescence  and 
during  the  five  days  ( about ) of  exfoliation.  Conceding  that  we  can  offer 
no  protection  during  the  first  four  days,  shall  we  therefore  offer  no  protec- 
tion during  the  remaining  ten  days?  * * * * Hardaway  says : ‘ Leav- 

ing out  of  account  sucklings  under  six  months  of  age,  in  whom  measles  is 
rare  and  said  to  be  slight,  most  deaths  from  the  disease  [measles]  occur 
among  very  young  children,  from  the  greater  liability  to  complications. 
According  to  Beddoes,  the  mortality  from  measles  is,  beyond  all  compari- 
son, greatest  in  the  second  year  of  life.’ — Pepper,  Vol.  I.,  p.  578.  Vital 
Statistics  of  Michigan,  1885,  says,  p.  221,  that  84.22  per  cent  of  the  deaths 
from  measles  in  that  year  occurred  in  children  under  five  years  of  age,  and 
that  only  2.63  were  above  twenty  years  of  age.” 

Importance  of  Restricting  Measles. 

Quain’s  Dictionary  states:  “The  annual  mortality  from  measles  in  Lon- 
don is  nearly  five  per  ten  thousand.”  In  Michigan,  the  reported  deaths 
from  measles  for  the  twelve  years,  1876-1887,  average  146  per  year.  If  we 
assume  that  only  three-fourths  of  the  deaths  were  reported,  the  deaths  in 
Michigan  from  measles  have  been  about  two  hundred  per  year. 

In  Measles , premises  should  be  placarded  and  finally  disinfected. 

After  considerable  discussion,  the  members  of  the  Board  expressed  the 
opinion  that  health  officers  should  placard  premises  where  measles  exists, 
and,  after  death  or  recovery,  should  disinfect  premises,  as  in  outbreaks  of 
other  diseases  “dangerous  to  the  public  health,”  measles  being  such  a dis- 
ease, and  as  such  coming  under  the  law  requiring  the  health  officer  to  take 
such  action.  The  law  also  requires  that  measles  shall  be  reported  by 
householders,  physicians,  and  health  officers. 

SANITARY  CONVENTIONS. 

Sanitary  Conventions  will  be  held  under  the  auspices  of  the  Board  at 
Battle  Creek,  June  25  and  26;  Alpena,  July  10  and  11,  and  at  Charlevoix, 
August  14  and  15. 

EXAMINATION  OF  PLANS  FOR  PROPOSED  NEW  BUILDING  AT  THE  MICHIGAN 

STATE  REFORM  SCHOOL. 

The  law  requires  that  before  the  final  adoption  of  plans  for  proposed 
new  buildings  at  the  State  Institutions  they  shall  be  submitted  to  the 
State  Board  of  Health  for  its  opinion  relative  to  the  provisions  for  the 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


heating,  ventilation,  sewerage  and  other  sanitary  appliances  and  arrange- 
ments. Boards  of  control  of  the  several  State  Institutions  are  not  required 
to  adopt  plans  approved  by  the  State  Board  of  Health  or  to  reject  plans 
disapproved  by  this  Board;  but  this  method  supplies  State  boards  of  con- 
trol with  reports  of  the  opinions  of  the  State  Board  of  Health  of  plans 
submitted  to  them  by  architects  and  others,  and  with  such  suggestions  for 
improvement  as  the  State  Board  of  Health  may  offer. 

At  this  meeting  of  the  State  Board  of  Health,  plans  for  a proposed  new 
main  building  at  the  State  Reform  School  were  submitted,  and  were  care- 
fully examined.  (A  committee  of  this  Board,  consisting  of  D/s.  J.  H. 
Kellogg  and  Henry  B.  Baker,  had  previously  examined  them. ) The  Sec- 
retary was  directed  to  transmit  the  report  to  the  Board  of  Control  of  the 
State  Reform  School;  and  a copy  will  be  published  in  the  Annual  Report 
of  the  State  Board  of  Health. 


SECRETARY’S  QUARTERLY  REPORT  OF  WORK  IN  THE 
OFFICE  OF  THE  BOARD  DURING  THE  QUARTER 
ENDING  APRIL  8,  1890. 

During  the  quarter  the  office  has  received  information  of  and  taken 
action  relative  to  145  outbreaks  of  diphtheria,  166  outbreaks  of  scarlet 
fever,  78  outbreaks  of  typhoid  fever,  and  114  outbreaks  of  measles.*  The 
usual  number  of  documents  on  the  restriction  of  these  diseases  (except 
measles)  have  been  sent  to  the  localities  where  these  diseases  prevailed. 
No  case  of  small-pox  has  been  reported  during  the  quarter. 

A circular  letter  and  blank  for  the  annual  return  of  the  name  and  address 
of  health  officer  have  been  sent  during  the  quarter  to  the  supervisors  of 
townships,  the  clerks  of  villages  and  cities  and  to  the  presidents  of  villages 
and  the  mayors  of  cities. 

During  the  quarter  103  books  and  pamphlets  have  been  received  and 
entered  in  the  library  of  this  Board,  mostly  in  exchange  for  the  publica- 
tions of  this  Board. 

During  the  quarter  ending  April  10,  1890,  there  have  been  received 
annual  reports  from  717  health  officers  and  688  clerks  of  townships,  cities 
and  villages,  making  a total  of  1,405  annual  reports  received,  as  against  a 
total  of  1,207  received  during  the  corresponding  quarter  of  1889,  and  864 
for  the  corresponding  quarter  of  1888. 

All  the  cases  and  deaths  from  diphtheria,  scarlet  fever,  typhoid  fever  and 
measles  mentioned  in  these  reports  have  been  compiled.  All  the  letters 
and  reports  received  concerning  the  dangerous  communicable  diseases  in 
Michigan  in  1889  have  been  assorted,  and  the  compilation  of  the  same  has 
been  begun. 

Three  hundred  and  twenty-two  blanks  giving  names  of  medical  practi- 
tioners have  been  received,  arranged  and  filed. 

During  the  quarter  a successful  sanitary  convention  was  held  at  Lapeer, 
and  an  invitation  has  been  received  for  a convention  at  Charlevoix  during 
the  coming  summer.  Steps  have  also  been  taken  at  Battle  Creek  for  a 
sanitary  convention  in  that  city. 


* Record  of  measles  was  not  begun  until  the  middle  of  the  quarter. 


ABSTRACT  OP  PROCEEDINGS  APRIL  15,  1890. 


7 


During  the  quarter,  1,800  pages  of  hektograph  work  have  been  executed. 

The  proceedings  of  the  sanitary  conventions  at  Pontiac  and  Vicksburg 
have  been  edited,  printed,  and  sent  to  those  who  took  part  in  the  conven- 
tions, to  libraries  (80  in  all),  to  the  secretaries  of  State  medical  societies, 
to  secretaries  of  State  boards  of  health,  to  sanitary  journals  and  exchanges, 
health  officers  of  cities  and  villages  in  Michigan,  the  health  officers  of  other 
States,  and  to  the  correspondents  of  this  Board.  A list  of  the  publications 
of  the  Board  which  may  be  had,  on  payment  of  postage,  was  sent  to  the 
health  officers  of  townships,  cities  and  villages.  In  response  to  requests 
(in  answer  to  this  list)  a large  number  of  reports,  supplements  and  reprints 
have  been  sent  out. 

A monthly  summary  of  meteorological  conditions  at  this  station  has  been 
regularly  sent  to  the  chief  signal  officer  at  Washington,  a briefer  one  sup- 
plied to  the  Director  of  the  Michigan  Weather  Service. 

The  computations  of  meteorological  registers  for  23  stations  in  Michigan 
during  the  year  1889  have  been  made. 

The  regular  weekly  and  monthly  bulletins  of  health  in  Michigan  have 
been  issued,  and  work  has  been  begun  on  the  compilation  of  the  weekly 
reports  of  diseases  for  1889. 

Twenty  diagrams  have  been  made  during  the  quarter  in  hektograph  ink, 
for  facilitating  studies  of  the  relations  of  certain  meteorological  conditions 
to  diseases,  and  two  of  these  diagrams  have  been  photo-engraved. 

Seventeen  hundred  and  sixty-two  newspapers  have  been  looked  over 
since  Feb.  14  for  reports  of  communicable  diseases.  This  has  resulted  in 
giving  this  office  information  of  the  occurrence  of  22  outbreaks  of  diph- 
theria, 24  outbreaks  of  scarlet  fever,  15  outbreaks  of  typhoid  fever,  and  61 
outbreaks  of  measles,  during  the  time  between  Feb.  14- Mar.  31,  1890. 


TABLE  4. — Showing  the  number  of  outbreaks  of  Diphtheria,  Scarlet  fever,  Typhoid  fever  and  Measles  from 
February  14,  to  March  31, 1800,  of  which  notice  was  received  at  the  office  of  the  Michigan  State  Board  of 
Health ; the  per  cent  of  reports,  information  concerning  which  was  received  through  the  newspapers ; the 
per  cent  of  newspaper  reports  which  were  confirmed  by  the  health  officer ; the  per  cent  of  newspaper  reports 
which  were  denied  by  the  health  officer,  and  the  per  cent  from  which  no  reply  was  received  from  the  health 
officer. 


Diseases. 

Reports 
from  all 
sources.  Feb. 
14— March  81, 
1890. 

Per  cent  of 
all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent  of 
n e w s p a per 
reports 
which  were 
confirmed  by 
the  health 
officer. 

Per  cent  of 
newspaper 
reports 
which  were 
denied  by 
the  health 
officer. 

Per  cent  of 
newspaper 
reports  to 
which  the 
health  officer 
made  no  re- 
ply to  notice 
sent  from 
this  office. 

Diphtheria . 

69 

32 

36 

27 

36 

Scarlet  fever... 

92 

26 

21 

29 

50 

Typhoid  fever ...  . . 

27 

56 

27 

33 

40 

Measles 

114 

54 

64 

5 

30 

Averages  for  the  four  Diseases 

42 

37 

24 

39 

8 


ABSTRACT  OP  PROCEEDINGS,  STATE  BOARD  OP  HEALTH. 


HEALTH  IN  MICHIGAN  IN  THE  FIRST  QUARTER  OF  1890. 

Communicable  Diseases. 

Compared  with  the  preceding  quarter  (October,  November  and  Decem- 
ber, 1889),  reports  received  from  all  sources  show  diphtheria  to  have 
decreased  by  an  average  of  three  places  per  month,  scarlet  fever  to  have 
increased  by  an  average  of  three  places  per  month,  typhoid  fever  to  have 
decreased  by  an  average  of  forty -eight  places  per  month,  measles  to  have 
increased  by  an  average  of  fifty-one  places  per  month,  and  smcdl-pox  to 
have  increased  by  an  average  of  one  place  per  month. 

Meteorology , and  Sickness  from  cdl  Causes , Compared  with  the  Pre- 
ceding Quarter. 

A comparison  of  meteorological  conditions  of  the  first  quarter  of  1890, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
temperature  to  have  been  lower,  the  absolute  humidity  to  have  been  less, 
the  relative  humidity  to  have  been  slightly  more,  and  the  day  and  the 
night  ozone  to  have  been  considerably  more  in  the  first  quarter  of  1890. 

Compared  with  the  preceding  quarter  (October,  November  and  Decem- 
ber, 1889),  the  reports  from  regular  observers  show  a marked  increase  of 
influenza,  pneumonia,  cerebro-spinal  meningitis,  measles,  pleuritis  and 
membranous  croup,  and  a marked  decrease  of  typho-malarial  fever,  typhoid 
fever  (enteric),  cholera  infantum,  small-pox,  cholera  morbus,  dysentery, 
inflammation  of  brain,  puerperal  fever,  intermittent  fever,  remittent  fever, 
diphtheria,  diarrhea  and  scarlet  fever  in  the  first  quarter  of  1890. 

This  Quarter  Compared  icith  the  Average  for  Four  Years,  1886-1889. 

A comparison  of  the  meteorological  conditions  of  the  first  quarter  of 
1890,  with  the  average  of  corresponding  quarters  in  the  three  years,  1886- 
1889,  shows  that  in  1890  the  temperature  was  slightly  higher,  the  absolute 
humidity  was  more,  the  relative  humidity  was  slightly  less,  and  the  day 
and  the  night  ozone  were  more  in  the  first  quarter  of  1890. 

Compared  with  the  average  for  the  corresponding  quarters  in  the  four 
years,  1886-1889,  the  reports  received  from  regular  observers  indicate 
that  influenza  and  measles  were  more  than  usually  prevalent,  and  that 
typho-malarial  fever,  typhoid  fever  (enteric),  small-pox,  scarlet  fever, 
cholera  morbus,  puerperal  fever,  dysentery  and  diphtheria  were  less  prev- 
alent in  the  first  quarter  of  1890. 

Henry  B.  Baker, 

Secretary. 


f 


ABSTRACT  OF  PROCEEDI 


THE  L13RARY  OF  THE 

JUN  2 5 1951 

ittSUY  OF  iLUNOiS 


OF  THE 


MICHIGAN  STATE  BOARD  OF  HEALTH 


MEETING  OCTOBER  14,  1890. 

[188.] 

REPORTED  BY  THE  SECRETARY  OF  THE  BOARD. 

The  regular  meeting  of  the  Michigan  State  Board  of  Health  was  held  in 
the  State  Capitol  in  Lansing,  October  14,  1890.  The  members  present 
were  as  follows:  Arthur  Hazlewood,  M.  D.,  Prof.  V.  C.  Vaughan,  M.  D., 
Prof.  Delos  Fall,  M.  S.,  and  Henry  B.  Baker,  M.  D.,  Secretary. 

The  regular  routine  business,  such  as  the  examination  and  auditing  of 
bills  and  accounts  was  first  transacted. 

PROTECTION  OF  THE  SCHOOL  POPULATION  FROM  CONSUMPTION. 

At  previous  meetings,  the  State  Board  of  Health  has  had  before  it  the 
subject  of  the  best  methods  for  the  restriction  and  prevention  of  consump- 
tion; and,  a few  years  ago,  published  its  opinion  that  all  sputa  from 
consumptive  persons  should  be  disinfected.  The  subject  has  also  been 
publicly  discussed,  by  the  Secretary  of  the  Board  and  others,  at  several 
Sanitary  Conventions  held  under  the  auspices  of  the  State  Board  of  Health, 
including  the  one  at  Pontiac,  referred  to  below. 

Just  previous  to  this  meeting  of  the  Board,  a letter  from  a valued  corres- 
pondent of  the  Board  was  presented  to  members  of  the  Board,  as  follows: — 


Milford,  Mich.,  Sept.  29,  1890. 

Dr.  H.  B.  Baker , Secy.  State  Board  of  Health : 

Dear  Sir — There  have  been  several  deaths  from  pulmonary  consumption  among  the  pupils  who  have 
attended  our  school  during  the  past  two  years,  and  as  I feared  our  building  might  be  infected  or  unsafe— 
I had  it  thoroughly  disinfected  with  bichloride  of  mercury.  There  is  now  in  attendance  a pupil  from  a 
family  where  there  have  been  several  fatal  cases  of  phthisis.  1 circulated  the  Reports  of  the  Pontiac 
Sanitary  Convention  sent  me,  and  several  of  the  pupils  are  afraid  to  attend  in  the  room  along  with  the 
pupil  who  is  coughing  and  is  suspected  to  have  consumption.  Can  our  sohool  boai’d  exclude  cases  of 
consumption  from  school  as  we  do  cases  of  scarlet  fever,  diphtheria,  etc.?  I am  quite  sure  there  are  other 
school-houses  in  our  county  that  are  unsafe,  also  churches  and  other  public  halls.  Would  it  not  be  well 
for  the  State  Board  of  Health  to  issue  a circular  to  school  boards  and  others  having  charge  of  churches 
and  public  buildings,  showing  the  necessity  for  thorough  disinfection  and  giving  a formula,  and  method 
for  thorough  (annual  or  semi-annual)  disinfection? 

Is  phthisis  officially  considered  to  be  communicable? 

Respectfully, 

Robt.  Johnston. 

Although,  by  leading  medical  and  sanitary  authorities,  consumption  is 
now  quite  generally  believed  to  be  a “communicable”  disease,  and  it  is 
known  to  be  one  of  the  most  dangerous,  yet  the  State  Board  of  Health  has 
not  officially  declared  the  opinion  that  it  is  a “ disease  dangerous  to  the 
public  health,”  as  the  term  is  in  the  Michigan  laws,  perhaps  for  the  reason 
that  under  existing  laws  the  health  officers  throughout  the  State  are 
generally  required,  under  penalties,  to  “give  public  notice  of  infected 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


places,  by  placard  on  the  premises,”  to  order  the  “ prompt  and  thorough 
isolation  of  those  sick”  with  snch  a disease,  and  to  do  other  acts  which  are 
important  relative  to  certain  other  diseases  which  endanger  the  public 
health,  but  which  are  not  yet  believed  by  sanitarians  to  be  judicious  to 
attempt  relative  to  consumption.  A pamphlet  is  in  preparation,  designed 
to  state  precisely  what  this  Board  deems  to  be  the  best  methods  for  the 
restriction  of  consumption.  However,  the  subject  of  the  protection  of  the 
school  population  from  consumption  is  so  important  that  the  Board 
considered  it  at  this  meeting,  in  advance  of  the  more  complete  document, 
and  adopted  the  preambles,  resolution,  and  statement  relative  to  disinfec- 
tion and  destruction  of  sputa  of  consumptives,  as  follows: — 

COUGHING  CONSUMPTIVES  SHOULD  BE  EXCLUDED  FROM  SCHOOLS. 

Whereas,  The  indoor  confinement  and  the  severe  competitive  work  of  the  schpol- 
room  tend  to  render  recovery  of  health  by  consumptive  pupils  impossible;  and, 

Whereas,  Except  consumptives  exercise  great  care  with  their  sputa,  and  except  the 
ventilation  is  such  as  to  cause  all  dust  to  pass  out  of  the  room  near  the  floor  level,  the 
presence  of  consumptives  in  the  school  room  may  endanger  the  health  and  lives  of  then- 
fellow  pupils, 

Resolved , That,  in  the  opinion  of  this  Board,  any  pupil  or  person  known  to  be  affected 
with  pulmonary  consumption  should  be  excluded  from  all  public  schools,  colleges,  and 
other  institutions  of  learning  until  such  pupil  or  person  is  so  far  recovered  from  con- 
sumption that  no  cough  or  expectoration  occurs.  * 

ALL  SPUTA  OF  CONSUMPTIVES  SHOULD  BE  DESTROYED  OR  DISINFECTED. 

As  a measure  for  the  restriction  of  the  spread  of  consumption,  this  Board  recommends 
the  destruction  or  disinfection  of  all  sputa  of  consumptives. 

This  can  be  done  if  each  consumptive  provides  himself  with  pieces  of  soft,  tough 
paper  that  has  been  paraffined  or  otherwise  made  waterproof,  each  piece  to  be  used  but 
once,  its  ends  immediately  so  twisted  as  to  allow  no  escape  of  the  sputa,  and  then 
enveloped  in  another  similar  paper,  similarly  twisted,  and  all  burned  at  the  first 
opportunity. 


The  importance  of  protecting  young  people  from  consumption  seems 
not  to  be  generally  sufficiently  understood.  Consumption  causes  more 
deaths  in  Michigan  than  does  any  other  disease.  A considerable  portion 
of  the  deaths  are  of  young  persons.  Thus,  in  1884,  no  less  than  20  per 
cent  of  all  the  deaths  reported  from  consumption  in  Michigan  were  of  per- 
sons under  twenty  years  of  age,  ( as  many  as  thirty-five  per  cent  were  under 
twenty-five  years  of  age).  Including  teachers  (some  of  whom,  however, 
are  over  twenty  years  of  age),  the  population  in  colleges  and  other  insti- 
tutions of  learning,  a large  portion  of  the  inhabitants  of  Michigan,  under 
the  age  of  twenty  years  are  in  school.  According  to  the  census  of  1884, 
about  87  per  cent  of  the  inhabitants  attended  school  during  the  year. 
According  to  the  Report  of  the  Superintendent  of  Public  Instruction,  for 
the  year  1889,  the  number  of  pupils  and  teachers,  in  that  year,  was  over 
480,000,  about  17,000  being  teachers. 

Consumption  may  come  to  the  school  population  in  other  ways  than  by 
school  attendance,  yet,  with  no  effort  at  restriction,  other  things  being 
equal,  the  greater  the  number  of  persons  in  an  assembly  the  greater 
the  chance  of  there  being  a person  present  infected  with,  and  capa- 
ble of  spreading,  the  disease.  Consumption  is  now  believed  to  be  most 
generally  spread  by  the  inhalation  of  dust  from  the  dried  sputa  of  con- 
sumptive persons.  And,  wdiile  it  may  not  yet  be  considered  judicious  to 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  14,  1890. 


3 


completely  isolate  all  consumptives,  it  does  seem  judicious  to  protect  all 
large  assemblies  of  persons  susceptible  to  consumption.  Unless  local 
boards  of  health  make  extraordinary  provision  therefor,*  there  are,  as  yet, 
no  special  guardians  of  assemblies  in  churches,  opera  houses,  theatres, 
etc. ; but  it  seems  to  be  practicable  for  school  officers,  on  the  ground  of 
public  policy,  to  regulate  the  attendance  in  schools,  and  to  exclude  there- 
from persons  suffering  from  dangerous  communicable  diseases.  If  a school 
board  cannot  legally  do  this  on  its  own  responsibility,  it  would  seem  that 
the  law  might  well  be  so  amended  that  it  can;  but  under  present  laws,  it 
should  be  able  to  enforce  the  orders  of  the  local  board  of  health,  respect- 
ing persons  whom  the  board  of  health  shall  decide  to  be  suffering  from  a 
dangerous  communicable  disease.  It  therefore  seems  to  be  practicable  to 
take  such  action  as  shall  probabty  result  in  a very  considerable  saving  of 
human  life,  and  among  a class  of  inhabitants  especially  worth  saving. 

The  attention  of  school  officers  throughout  the  State  is  especially  called 
to  this  subject. 

The  public-health  interests  of  the  State  will  also  gain  greatly  if  the 
modes  of  spread  of  the  most  dangerous  communicable  diseases  shall  come 
to  be  well  known  to  the  school  population  of  the  State.  The  office  of  the 
Secretary  of  the  State  Board  of  Health  holds  itself  in  readiness,  at  all 
times,  to  do  what  it  can  to  aid  school  officers  and  teachers  toward  the 
accomplishment  of  that  very  desirable  object. 

TYPHOID  FEVER  SUPPOSED  TO  HAVE  BEEN  CAUSED  BY  WATER  OR  MILK. 

Preliminary  Report. 

A valued  correspondent  of  this  Board  wTrote,  Sept.  28,  that  typhoid  fever 
had  been  unusually  prevalent  in  his  vicinity  this  Autumn;  cases  had 
occurred  among  persons  using  the  water  from  wells,  and  among  those  using 
water  from  the  river,  and  such  a number  had  occurred  among  users  of  milk 
from  one  particular  cow  that  the  question  had  arisen  whether  the  disease 
was  all  spread  by  the  milk,  or  whether  one  or  both  sources  of  water  were 
to  be  charged  with  its  causation. 

Samples  of  the  milk,  of  the  river  water,  and  of  the  well  water  were  sent 
to  Prof.  Vaughan,  Director  of  the  Laboratory  of  Hygiene,  Ann  Arbor,  and 
at  this  meeting  he  made  a verbal  preliminary  report  that  bacteriological 
examination  revealed  the  fact  that  both  of  the  samples  of  water  and  the 
milk  contained  micro-organisms  wffiich,  by  their  life  processes,  in  nutritive 
solutions,  form  poisons. 

THE  PRESENT  COMPARATIVE  IMMUNITY  OF  ADULTS  FROM  DIPHTHERIA. 

{The  Beginning  of  a Statistical  Study.) 

Dr.  Baker  presented  a table  and  an  illustrative  diagram  exhibiting  the 
epidemic-waves  of  diphtheria  in  England  during  the  period  1855-1888, 
inclusive.  The  part  representing  the  period,  1855-1881,  was  published  in 
the  Proceedings  of  the  Sanitary  Convention  held  at  Beed  City  in  April, 
1883;  but  Dr.  Baker  has  now  extended  the  statistics  and  the  diagram  to 
1888,  and  has  associated  with  it  evidence  as  to  the  change  which  has  taken 
place  in  the  age  of  decedents  from  diphtheria  in  England. 


* Under  §1647  or  §1673  Howell’s  Statutes. 


TABLE  1.  Epidemic  Waves.— Deaths  from  Diphtheria  in  England  and  in  Michigan  for  Years  Stated. 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


1888 

4815 

168 

717 

1887 

4443 

157 

935 

1886 

4098 

147 

1117 

1885 

4471 

163 

1054 

1 1 

ra  rs  1 1 
IS  s r 

So  I 
qo 

4218 

158 

1007 

I 

00 

00 

3992 

151 

1416 

( 

1881 

3153 

121 

2063 

1880 

2810 

109 

1542 

1879 

3053 

120 

1473 

1878 

3498 

140 

887 

1877 

2731 

111 

593 

1876 



3151 

129 

311 

1875 

3415 

142 

207 

1874 

3560 

150 

213 

1873 

2531 

108 

217 

^ 1 

g ! 

2152 

93 

192 

1871 

2525 

111 

121 

1870 

2699 

120 

121 

1869 

2606 

117 

89 

1868; 

3013 

137 

1867 



2600 

120 

110 

9981 

3000 

140 

1 

4145 

196 

1864 

5464 

261 

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1862 

4903 

241 

1861 

4517 

225 

1 

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fft  flP 

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1858 

8 8 

to  00 

1857 

1583 

82 

?o 

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00  <03 

s - 

1855 

1 S 

PLACES. 

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theria  is  usually  not  fatal  to  adults,  to  be  explained  (altogether  or  in  part)  by  their  having  had  the  disease  once  in 
early  life?  If  this  hypothesis  is  the  true  explanation,  then  when  diphtheria  first  reaches  a country  there  should  be 
a much  larger  proportion  of  adults  among  the  decedents  than  there  is  afterwards;  because  at  first  the  adults  would 
not  be  protected  through  having  had  the  disease,  while  afterwards,  if  the  disease  becomes  general  and  permanent, 
many  of  the  adults  would  be  thus  protected,  in  case  immunity  is  thus  obtained. 


EPIDEMIC  WAVES — DEATHS  FROM  DIPHTHERIA  IN  ENGLAND,  YEARS  1853-SS-* 


ABSTRACT  OP  PROCEEDINGS,  OCTOBER  14,  1890. 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


6 


Notwithstanding  the  belief  among  statisticians  that  in  the  mortality 
statistics  in  England,  diphtheria  was  first  separated  from  scarlet  fever  in 
1855,  Dr.  Baker  expressed  the  view,  based  upon  his  examination  of  the 
evidence,  that  it  seemed  to  him  probable  that  diphtheria  first  reached,  and 
commenced  to  spread  through,  England  in  1855, — that  previous  to  1855 
there  was  very  little  if  any  real  diphtheria  which  could  have  been  separated 
from  scarlet  fever.  Dr.  Hazlewood,  president  pro  tern,  of  the  State  Board 
of  Health  at  this  meeting,  and  who  in  early  life  was  a medical  student  in 
England,  expressed  a similar  view’. 

TABLE  2. — Deaths  from  Diphtheria  in  England. 


t 

Years. 

Diphtheria  Decedents. 

Deaths  from  Diph- 
theria per  Million 
Inhabitants.* 

Per  Cent' Under 
10  Years  of  Age. 

Per  Cent  Over  10 
Years  of  Age. 

1857 

f 85.48 

t 14.52 

82 

1859 

79.22 

20.78 

517  | 

1860 

79.82 

20.18 

261 

1861 

79.37 

20.63 

225 

1868 

82.60 

17.40 

137 

1869 

81.77 

18.23 

117 

1870 

80.77 

19.23 

120 

1871 __  __ 

81.59 

18.41 

111 

1872 

81.18 

18.82 

93 

1873 

83.21 

16.79 

108 

1 1874 

80.67 

19.33 

150 

1 1875 

80.81 

19.19 

142 

I 1876 

82.70 

17.30 

129 

1877 

82.52 

17.48 

111 

1878 

83.28 

16.72 

140 

1879 

82.44 

17.56 

120 

1880 

83.47 

16.53 

109 

1882 

84.97 

15.03 

151 

1883 

84.57 

15.43 

158 

1884 

84.06 

J5.94 

185 

1885 

83.74 

16.26 

163 

1886 

84.82 

15.18 

147 

1887  

86.41 

13.59 

157 

1888 

87.16 

12.84 

168 

* Fiftieth  Animal  Report,  Registrar-General  of  England,  1887,  page  lviii. 

t For  the  year  1857  only  310  deaths  of  persons  at  all  ages  were  included  in  the  table,  therefore  these 
figures  may  not  supply  very  reliable  evidence  on  this  point,  for  that  year;  but  if  the  evidence  is  good, 
there  is  a possible  explanation  further  on. 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  14,  1890. 


7 


Diphtheria  reached  its  maximum  prevalence  in  England  in  1859,  in  which 
year  over  10,000  deaths  from  it  were  reported.  Among  the  decedents 
from  diphtheria  in  England  in  1859  was  there  a larger  proportion  of  adult 
persons  than  there  has  been  since  that  time?  Examination  of  the  statis- 
tics seems  to  prove  that  there  was:  The  proportion  of  decedents  over  ten 
years  of  age  has  been  gradually  decreasing  since  1859,  in  England,  and, 
conversely,  the  proportion  of  the  decedents  that  are  under  ten  years  of  age 
has  been  correspondingly  increasing.  The  proportions  in  decedents  in  each 
of  specified  years  (taken  somewhat  at  random)  are  shown  in  Table  2, 
above. 

If  it  is  true  that  diphtheria  first  gained  a permanent  existence  in  England 
in  1855 ; and  if  once  having  diphtheria  confers  comparative  immunity  from 
the  disease,  then  diphtheria  should  have  caused  a greater  mortality  when 
it  first  spread  through  England  than  it  ever  did  afterwards.  Table  1,  and 
especially  the  diagram  shows  that  this  is  the  fact, — that  there  were  more 
deaths  from  diphtheria  in  England  in  1859  than  there  has  been  in  any  year 
since,  notwithstanding  a considerable  increase  in  the  population.* 

That  there  shall  be  gained  a knowledge  of  the  reason  why  adults  now 
have  comparative  immunity  from  diphtheria  is  important,  for  several  rea- 
sons: If  the  immunity  is  gained  only  or  chiefly  through  having  the  dis- 
ease, then,  if  through  isolation  of  cases,  and  thorough  disinfection,  the  dis- 
ease shall  be  generally  greatly  lessened,  j there  will  gradually  be  a lessening 
of  the  proportion  of  adults  who  are  comparatively  immune,  that  is  to  say 
there  will  be  a correspondingly  large  proportion  of  adults  who  may  have 
fatal  diphtheria  whenever  the  disease  does  come  to  them;  and  instead  of 
the  disease  being,  as  it  now  is,  a disease  fatal  chiefly  to  children  it  would 
become  fatal  also  to  adults. 

On  the  other  hand,  if  the  comparative  immunity  of  adults  is  due  to  their 
power  for  resisting  the  disease  being  greater  than  it  is  among  children, 
through  influences  incident  to  age  alone  ( such,  for  instance,  as  tougher  skin 
and  mucous  membrane  of  throat),  then  the  practical  sanitarians  have  a 
more  simple  task  before  them. 

Some  of  the  facts  developed  by  this  study  of  the  statistics  of  England 
and  of  Michigan-are  more  in  accord  with  the  last-mentioned  hypothesis 
than  with  the  idea  that  the  immunity  is  due  chiefly  to  having  had  the  dis- 
ease. Eor  instance,  it  seems  that  in  the  very  first  year  (1857)  for  which 
the  computation  could  be  made  in  England,  the  per  cent  of  decedents  aged 
under  ten  years  was  85.48,  which  is  about  the  average  of  late  years.  This 
is  shown  in  the  first  line  in  Table  2. 

Then  in  the  table  ( No.  3 ) for  Michigan,  it  is  seen  that  there  was  not 
from  the  first  a gradual  decrease  of  proportion  of  adults  among  the  dece- 
dents from  diphtheria,  but  the  table  shows  that  generally  in  those  years 
when  the  deaths  were  most  numerous  there  was  the  greatest  proportion  of 
adult  decedents.  J This  might  be  the  case  if  we  suppose  that  the  increase 
in  the  mortality  from  diphtheria  in  those  years  was  due  not  altogether  to 
an  increased  number  of  susceptible  persons  among  the  inhabitants,  but 
also  to  greater  intensity  of  the  diphtheritic  virus  in  those  years,  or  to  a 
greater  intensity  of  meteorological  conditions  favoring  the  disease. 

*It  is  proper  to  state  that,  although  this  is  true  for  England  as  a whole,  in  the  city  of  London,  by  itself, 
there  was  a slightly  greater  reported  death-rate  from  diphtheria  in  1888  than  in  1859. 

t There  is  good  evidence  that  this  is  now  being  done  in  Michigan. 

X As  may  be  seen  by  the  last  three  lines  in  Table  3,  relative  to  diphtheria  in  Michigan,  when  the 
reported  deaths  from  diphtheria  are  over  five-tenths  of  one  death  per  thousand  inhabitants,  the  average 
per  cent  of  diphtheria  decedents  over  ten  years  of  age  is  22.55,  and  when  the  reported  deaths  from  diph- 
theria are  less  than  five-tenths  of  one  death  per  thousaud  inhabitants,  the  average  per  cent  of  diphtheria 
decedents  over  ten  years  of  age  is  19.27.  (The  average  per  cent  of  diphtheria  decedeuts  aged  over  ten 
ears  is  20.68.) 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


TABLE  3. — Deaths  from  Diphtheria  in  Michigan , for  each  of  the  twenty-one  Years 
1868-1888 ; Per  Cent  of  Decedents  Under  Ten  Years  of  Age ; Per  Cent  of  Decedents 
Over  Ten  Years  of  Age ; Number  of  Deaths  at  all  Ages ; Estimated  Population ; and 
Reported  Deaths  per  one  thousand  Inhabitants.  Average  for  the  years  1868- 77, 
1887-88,  when  the  death-rate  was  more  than  five-tenths  of  one  death  per  thousand 
inhabitants ; average  for  the  years  1878-86,  when  the  death-rate  was  less  than  five  - 
tenths  of  one  death ; and,  average  for  the  whole  series  of  years  1868-88. 


Diphtheria  Decedents. 

Total  Deaths 
from 

Diphtheria 
at  all  Ages. 

Estimated 
Population,  in 
June  of  each 
Year.  * 

y.-_.  ' . ; i 

Reported 
Deaths  from 
Diphtheria 
per  1,000 
Inhabitants. 

Year. 

Per  cent 
Under  10 
years  of  Age. 

Per  cent 
Over  10 
years  of  Age. 

1868  

f75.00 

25.00 

72 

1,080,906 

-1 

1869  

79.78 

20.22 

89 

1,131,600 

.08 

1870  

83.47 

16.53 

121 

Jl,  184.282 

.10 

1871 

82.64 

17.36 

121 

1,223,176 

.10 

1872  

80.21 

19.79 

192 

1,263,352 

.15  i 

1873  

84.79 

15.21 

217 

1,304,842 

.17 

1874  

85.45 

14.55 

213 

1,347,678 

.16  j 

1875  1 — 

81.64 

18.86 

207 

1,391,927 

.15  1 

1876  

78.14 

21.86 

311 

1,437,621 

.22 

1877  

77.91 

22.09 

593 

1.484,824 

.40 

1878  

1 

76.10 

f 23.90 

1 

887 

1,533,573 

1 

r .58 

1879  

77.12 

22.88 

i 

1,473 

1,583,932 

1 

.93  | 

1880  

78.15 

| 21.85 

1,542 

Jl, 636, 937 

1 

.94 

1881 

74.80 

! 25.20 

2,063 

1,677,346 

1.23 

i 

1882  

76.55 

-{  23.45 

1,416 

1,718,761 

* 

.82 

1883  

80.24 

| 19.76 

1.007 

1,761,202 

.57 

1884  

80.47 

! 19.53 

1,065 

§1,804,699 

I .59 

1885  

77.99 

| 22.01 

1,054 

1,849,258 

.52 

1886  

75.65 

124.35 

1,117 

1,894,928 

.59 

1887  

78.82 

21.18 

935 

1,941,710 

.48 

1888 

80.89 

19.11 

717 

1,989,653 

.36 

1889  ....  

! 2,038,784 

1890 

! 

12,089,792 

1868-77.  1887-88 

80.73 

19.27 

.20 

1878-86  ..  

77.45 

22.55 

.75  1 

1868-88  (Av.  for  whole  series) 

79.32 

20.68 

.44 

*The  statememts  of  the  estimated  population  for  the  years  1868  and  1869  werp  taken  from  the  “Intro- 
duction” to  the  “Statistics  of  Michigan  1870,”  page  lxxx;  those  for  the  years  1870, 1880,  and  1890  were  of 
the  exact  numbers  of  inhabitants  as  enumerated  for  the  U.  S.  census;  for  the  remaining  years,  they  were 
estimated  by  taking  the  figures  of  the  U.  S.  census  of  1870,  1880,  and  1890  and  computing  for  each  decen- 
nial period,  the  annual  increase  per  1,000  inhabitants.  From  1870  to  1880  this  was,  approximately,  82.85; 
and  from  1880  to  1890  it  was  about  24.7.  The  figures  in  Michigan  censuses  in  1864,  1874,  and  1884  were  not 
used  for  the  purpose  of  this  estimation,  nor  in  this  table  for  the  census  years,  because  the  State  censuses  for 
1864  and  1874  were  taken  at  a different  time  of  the  year  from  that  of  the  U.  S.  censuses,  and,  although  the 
State  census  for  1884  showed  a greater  population  than  the  estimate  based  on  the  preceding  and  succeed- 
ing U.  S.  censuses,  the  State  census  figures  could  not  be  used  because  not  comparable  with  those  for  the 
other  years  estimated  from  the  annual  increase  per  1,000  inhabitants  according  to  the  U.  S.  census, 
t For  the  last  nine  (9)  months  of  the  year  1868. 
i According  to  the  U.  S.  census. 

§The  population  of  Michigan  in  June,  1884,  according  to  the  State  census,  was  1,858,658. 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  14,  1890. 


9 

The  meteorological  conditions  favoring  the  disease  in  any  given  year  are 
well  shown  in  tables  and  diagrams  in  various  articles  prepared  by  myself, 
and  published  by  this  State  Board  of  Health;  speaking  generally,  the  evi- 
dence is  conclusive  that  diphtheria  rises  after  the  cold  months,  and  falls 
after  the  warm  months;  but  this  study  has  not  yet  been  extended  so  as  to 
show  whether  the  same  general  law  holds  true  by  years  as  it  does  by 
months. 

NONE  BUT  WELL-QUALIFIED  PHYSICIANS. 

PROPOSED  LEGAL  ORGANIZATION  OF  THE  ENTIRE  MEDICAL  PROFESSION  OF 

THE  STATE. 

At  this  meeting  of  the  Board,  the  subject  of  an  attempt  to  stop  the  con- 
tinued influx  of  unqualified  practitioners  was  brought  up,  through  a com- 
munication to  the  Secretary  of  the  Board,  from  George  Duffield,  M.  D.,  Sec. 
of  a committee  of  the  State  Medical  Society,  whereupon  the  following  pre- 
amble and  resolutions  were  adopted: 

Whereas,  It  is  agreed  by  all  classes  of  people  that  the  public  health  would  be  much 
better  protected  if  none  but  properly-qualified  persons  were  permitted  to  practice  med 
icine,  and  thus  to  have  in  their  keeping  measures  relative  to  life  and  death. 

Resolved , That  it  is  believed  to  be  practicable,  through  judicious  legislation,  to  so 
organize  the  present  legal  medical  practitioners  in  Michigan,  as  that  through  represent- 
atives, elected  by  themselves,  they  shall  guard  the  entrance  to  the  profession,  by  a pre- 
liminary examination  of  students,  and  a final  examination  of  graduates  of  colleges  and 
of  proposed  practitioners  who  come  from  other  States,  so  that  the  entire  medical  pro- 
fession of  this  State  shall  be  united  in  the  effort  to  improve  the  qualifications  of  its 
new  members. 

Resolved , That  the  Secretary  of  this  Board  be  directed  to  transmit  a copy  of  the  fore- 
going preamble  and  resolution  to  the  chairmen  of  the  committees  on  public  health  in 
the  Senate  and  House  of  Representatives  in  the  State  Legislature,  as  soon  as  it  is  in 

session. 

SECRETARY’S  REPORT  OF  WORK  IN  THE  OFFICE  OF  THE  STATE  BOARD  OF  HEALTH 
DURING  THE  SIX  MONTHS  ENDING  OCTORER  13,  1890. 

During  the  last  two  quarters  the  office  has  received  information  of,  and 
taken  action  relative  to  221  outbreaks  of  diphtheria,  202  outbreaks  of  scar- 
let fever,  179  outbreaks  of  typhoid  fever,  and  243  outbreaks  of  measles. 
The  usual  numbers  of  pamphlets  on  the  restriction  of  these  diseases  have 
been  sent  to  the  localities  where  these  diseases  prevailed.  No  case  of  small- 
pox has  been  reported  during  the  second  and  third  quarters  of  1890. 

A little  over  1,700  pages  of  letter-copy  book  have  been  used  since  the 
April  meeting. 

The  Public-health  Laws  of  Michigan,  compiled  last  year,  have  been  care- 
fully examined,  the  proof  on  the  compilation  has  been  read,  table  of  contents 
and  index  prepared,  and  the  book  is  nearly  ready  for  distribution. 

The  copy  for  that  part  of  the  Annual  Beport  for  the  year  1889  which 
follows  the  articles  on  meteorology  and  the  weekly  reports  of  diseases  has 
been  carefully  edited  and  the  articles  up  to  the  one  relative  to  typhoid  fever 
have  been  printed.  The  last  part  of  the  article  relative  to  typhoid  fever, 
was  somewhat  delayed  by  the  preparation  of  further  evidence  on  the 
relation  of  low  water  in  wells,  and  the  height  of  ground  above  the  ground 
water,  to  the  prevalence  of  typhoid  fever  in  Michigan. 

ANNUAL  REPORTS  OF  HEALTH  OFFICERS  AND  CLERKS,  AND  THEIR  COMPILATION. 

Since  the  last  regular  meeting  of  this  Board  a compilation  has  been 
made  from  the  annual  reports  of  health  officers  and  clerks  of  local  boards, 
the  compilation  including  all  the  deaths  and  cases  reported  as  having 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


occurred  during  the  year  1889,  from  the  following-named  dangerous  com- 
municable diseases: — diphtheria,  scarlet  fever,  typhoid  fever,  measles,  and 
whooping-cough.  The  information  from  this  source  is  to  be  united  with 
that  from  the  special  reports  relative  to  those  diseases,  and  with  that 
derived  from  the  weekly  postal-reports.  The  whole  number  of  annual 
reports  from  which  the  compilations  were  made,  are  as  follows: — 

From  health  officers 732 

From  clerks t _ _ 700 


Total . 1,432 

REPORTS  OF  NAMES  AND  ADDRESSES  OF  PRACTICING  PHYSICIANS. 

Under  the  law,  Act  No.  268,  Laws  of  1887,  it  is  the  duty  of  the  supervisor 
at  the  time  of  making  the  annual  assessment  in  each  year,  to  make  a list  of 
all  physicians  within  his  township,  village,  ward,  or  city  as  the  case  may  be, 
and  to  return  such  list  to  the  village  or  city  clerk,  “and  annually  on  or 
before  the  first  day  of  January,  such  clerks  shall  furnish  certified  lists  of 
the  same  to  the  Secretary  of  the  State  Board  of  Health.”  This  law  is  not 
being  generally  obeyed.  During  the  year  1890  only  429  out  of  a possible 
1,517  reports  have  been  received,  and  most  of  these  reports  have  come  from 
townships  and  small  villages,  in  which  the  population  was  not  great,  in 
many  cases  there  being  no  physician  in  the  township.  The  result  is,  that 
the  intention  of  the  law  to  supply  to  the  office  of  the  State  Board  of  Health 
information  relative  to  the  medical  practitioners  throughout  the  State,  is 
not  fulfilled  and  the  information  has  to  be  obtained  from  other  sources. 
The  best  available  source  is  the  “Medical  and  Surgical  Directory”  compiled 
by  R.  L.  Polk  & Co.,  of  Detroit,  but  the  latest  edition  seems  to  be  not 
later  than  that  of  1886. 

METEOROLOGICAL  REPORTS  AND  WORK  IN  THE  OFFICE. 

Since  the  last  report  (April,  1890),  the  weekly  and  monthly  summary  of 
meteorological  conditions  at  this  station  have  been  made,  and  a copy  of 
the  monthly  summary  sent,  each  month,  to  the  Chief  Signal  Officer  at 
Washington,  D.  C.,  and  also  a copy  to  Sergt.  N.  B.  Conger,  Director  of  the 
Michigan  State  Weather  Service,  at  Lansing,  Mich. 

Compilations  of  the  meteorological  conditions  for  the  year  1889,  at  24 
stations  in  different  parts  of  the  State,  are  nearly  completed,  and  26  dia- 
grams made  in  the  photo-engraver’s  ink,  ready  for  the  photo-engraver. 

Meteorological  registers  have  been  received  and  examined  from  22  sta- 
tions in  Michigan — for  each  of  the  months,  April  to  August,  and  from 
nearly  all  of  those  stations  for  September,  1890.  The  computation  of  all 
the  meteorological  conditions  on  these  registers  from  J anuary  to  August, 
1890,  has  been  made  (but  not  proved)  except  for  the  absolute  and  relative 
humidity,  observations  of  the  barometer,  and  of  fog. 

SANITARY  CONVENTIONS  HELD. 

Two  successful  sanitary  conventions  wTere  held,  one  at  Alpena,  J uly  10 
and  11,  and  one  at  Charlevoix,  August  14  and  15.  These  were  attended  by 
the  secretary,  as  well  as  by  other  members  of  this  board. 

A PUBLIC  MEETING  AT  HOLLAND,  OTTAWA  COUNTY. 

On  account  of  difficulty  in  restricting  diphtheria,  the  health  officer  and 
other  prominent  citizens  of  Holland  asked  that  a sanitary  convention, 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  14,  1890. 


11 


under  the  auspices  of  the  State  Board  of  Health,  be  held  in  Holland;  and 
arrangements  were  made  for  one;  but  the  time  set  for  it  was  so  distant 
that  it  seemed  desirable  to  hold  at  once  a public  meeting  for  the  special 
purpose  of  placing  before  the  citizens  generally  the  best  means  for  the 
restriction  of  diphtheria.  July  17,  such  a public  meeting  was  held,  at 
. which  the  mayor  of  the  city  presided;  and,  on  invitation  received  from 
the  board  of  health  of  Holland,  Doctors  Avery,  Hazlewood,  and  Baker,  of 
the  State  Board  of  Health,  attended  and  spoke  at  the  meeting.  The 
secretary  of  this  board  also  distributed  to  the  audience,  which  was  a large 
one,  copies  of  the  documents,  issued  by  the  State  Board  of  Health,  on  the 
best  measures  for  the  restriction  of  diphtheria. 

NOTICES,  PAMPHLETS,  BLANKS,  ETC.,  ISSUED. 

Announcements  for  Sanitary  Conventions  to  be  held  at  Holland,  Niles, 
and  Centerville,  have  been  printed  and  liberally  distributed.  Programs 
for  the  Sanitary  Conventions  held  at  Alpena  and  Charlevoix  were  printed 
and  distributed.  Announcements  for  the  postponement  of  the  Convention 
at  Holland  have  been  distributed  in  order  that  those  previously  invited, 
might  not  be  misled  into  going  at  the  wrong  time. 

At  the  Alpena  Convention  about  250  copies  of  pamphlet  Supplements 
to  the  Annual  Reports  of  this  Board  and  103  sets  of  pamphlets  and  dia- 
grams were  distributed.  At  the  Charlevoix  Convention  about  50  sets  of 
pamphlets  and  diagrams,  and  about  120  copies  of  pamphlet  proceedings  of 
sanitary  conventions  were  distributed.  The  usual  number  of  pamphlets 
have  been  sent  where  communicable  diseases  prevailed,  supplying  instruc- 
tions how  to  restrict  such  diseases.  The  list  of  health  officers  for  town- 
ships, villages,  and  cities  has  been  compiled,  printed,  and  sent  to  all  the 
health  officers,  and  to  the  supervisors  or  presidents  of  villages  and  mayors 
of  cities  where  no  health  officer  was  returned.  The  number  of  copies  sent 
out  was  about  1,519;  this  being  the  number  of  local  boards  of  health  in 
Michigan. 

The  usual  documents,  pamphlets,  blanks,  etc.,  have  been  sent  to  each 
health  officer  of  a township,  village,  and  city  as  soon  as  his  name  was 
returned;  also  to  the  clerk  of  each  township,  village,  and  city  who  made 
report  of  the  name  of  a health  officer  for  his  township,  village,  or  city. 

The  usual  work  of  keeping  a record  of  the  documents  sent  out  from,  and 
received  in  the  office  has  been  kept  up. 

JOURNALS,  BOOKS,  AND  PAMPHLETS  RECEIVED. 

During  the  last  two  quarters,  the  numbers  of  journals  received  at  the 
office  of  the  State  Board  of  Health,  mainly  in  exchange  for  the  publications 
of  this  Board,  were  as  follows : 


Journals. 

First 

Quarter. 

Second 

Quarter. 

Quarterly ... 

_ | 

4 

1 

Monthly . 

134 

111 

Semi-Monthly 

37 

37 

Weekly _ 

284 

266 

During  the  quarter  ending  June  30,  1890,  there  were  120  books  and 
pamphlets  added  to  the  library  of  the  Board. 


12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Among  the  hecktograph  work  clone  during  this  second  quarter,  were 
copies  of  report,  and  supplementary  report,  of  examination  by  this  Board 
of  plans  for  the  new  buildings  at  the  State  Reform  School. 

During  the  quarter  ending  Sept.  30,  1890,  there  were  98  books  and 
pamphlets 'added  to  the  library  of  the  Board. 

Hecktograph  and  mimeograph  work  was  made,  during  the  third  quarter 
to  the  number  of  3,057  pages,  among  which  were  letters  on  “ Sulphurous 
Disinfection”  and  “How  Diphtheria  is  Spread  by  Corpses;”  said  articles 
were  distributed  to  members  of  the  Board,  sanitary  exchanges,  secretaries 
of  other  State  Boards  of  Health,  and  others  where  it  was  thought  they  would 
do  good. 

COMMUNICABLE  DISEASES. 

Quarter  Ending  June  30, 1890. 

The  number  of  outbreaks  of  communicable  diseases  of  which  information 
was  received,  from  all  sources,  and  filed,  and  the  corresponding  numbers  of 
special  letters  sent  during  the  quarter,  were  as  follows: — for  diphtheria, 
118;  scarlet  fever,  94;  typhoid  and  typho-malarial  fever,  52;  measles,  189. 
Total  for  the  five  diseases,  453.  (No  small-pox  was  reported.) 

The  “Final”  reports  received  and  filed  during  the  quarter,  were:  for 
diphtheria,  65;  scarlet  fever,  76;  typhoid  and  typho-malarial  fever,  18; 
measles,  8. 

Written  cards  and  demands  for  weekly  or  final  reports,  on  cards,  or  in 
the  form  of  the  circular  letter,  were  sent  during  the  quarter,  to  the  number 
of  792.  Besides  this,  card  receipts  for  communications  from  health  officers 
and  others  were  sent  of  which  no  record  is  kept. 

Newspapers  have  been  looked  over  during  the  quarter  for  reports  of 
communicable  diseases  to  the  number  of  2,348.  This  has  resulted  in  giving 
this  office  information  of  the  occurrence  of  24  outbreaks  of  diphtheria,  8 
outbreaks  of  scarlet  fever,  15  outbreaks  of  typhoid  and  typho-malarial  fever, 
and  64  outbreaks  of  measles,  during  the  quarter. 

TABLE  4.-  Showing  the  number  of  outbreaks  of  Diphtheria,  Scarlet  fever,  Typhoid  fever 
and  Measles,  from  April  1,  to  June  30,  1890,  of  which  notice  was  received  at  the  office 
of  the  Michigan  State  Board  of  Health ; the  per  cent  of  reports,  information  concern- 
ing which  was  received  through  the  newspapers ; the  per  cent  of  newspaper  reports 
which  were  confirmed  by  the  health  officer : the  per  cent  of  newspaper  reports  which 
were  denied  by  the  health  officer,  and  the  per  cent  from  which  no  reply  was  received 
from  the  health  officer. 


DISEASES. 

Reports  from 
all  sources. 
April  1— June 
30,  1890. 

! 

Per  cent  of 
all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent  of 
newspaper 
reports 
which  were 
confirmed  by 
the  health 
officer. 

Per  cent  of 
ne  w s p a p er 
reports 
which  were 
denied  by 
the  health 
officer. 

• 

Per  cent  of 
newspaper 
reports  to 
which  the 
health  officer 
made  no  re- 
ply to  notice 
sent  from 
this  office. 

Diphtheria..  . ... __ 

118 

20 

29 

29 

42 

Scarlet  fever ..  .. 

94 

9 

38 

25 

38 

1 Typhoid  fever..  

52 

29 

13 

20 

67 

Measles.  ..  

189 

34 

38 

20 

42 

Averages  for  the  four  Diseases  . . . 

23 

29 

24 

47 

ABSTRACT  OP  PROCEEDINGS,  OCTOBER  14,  1890. 


13 


COMMUNICABLE  DISEASES. 

Quarter  Ending  Sept.  30,  1890. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  diseases 
received  from  all  sources  and  filed,  and  the  corresponding  number  of  cir- 
cular letters  sent  during  the  quarter,  are  as  follows:  for  diphtheria,  103; 
for  scarlet  fever,  108 ; for  typhoid  and  typho-malarial  fever,  127 ; for  meas- 
les, 54.  Total  for  the  five  diseases,  392.  (No  small-pox  was  reported.) 

The  “Final”  reports  received  and  filed  during  the  quarter,  were:  for 
diphtheria,  76;  scarlet  fever,  73;  typhoid  and  typho-malarial  fever,  33; 
measles,  19.  Total  for  the  five  diseases,  201. 

Written  cards,  and  demands  for  weekly  or  final  reports,  on  cards,  or  in  the 
form  of  the  circular  letter,  were  sent  out  during  the  quarter,  to  the  number 
of  539, 

Newspapers  (local  columns)  have  been  looked  over  during  the  quarter 
for  reports  of  communicable  diseases,  to  the  number  of  1,844.  This  has 
resulted  in  giving  this  office  information  of  the  occurrence  of  12  outbreaks  of 
diphtheria,  11  outbreaks  of  scarlet  fever,  16  outbreaks  of  typhoid  and  typho- 
malarial  fever, and  3 outbreaks  of  measles. 

The  number  of  communications  relative  to  dangerous  communicable  dis- 
eases received  and  placed  on  file  during  the  quarter  was  977. 

TABLE  5. — Showing  the  number  of  outbreaks  of  Diphtheria , Scarlet  fever , Typhoid 
fever  and  Measles  from  July  1 to  September  30,  1890,  of  which  notice  was  received 
at  the  office  of  the  Michigan  State  Board  of  Health ; the  per  cent  of  reports , infor- 
mation concerning  which  was  received  through  the  newspapers ; the  per  cent  of 
newspaper  repoi'ts  which  were  confirmed  by  the  health  officer ; the  per  cent  of  news- 
paper reports  which  were  denied  by  the  health  officer,  and  the  per  cent  from  which 
no  reply  was  received  from  the  health  officer. 


Diseases. 

K e p o r t s 
from  all 
sources.  July 
1,  Sept.  30, 
1890. 

Per  cent  of 
all  reports 
whichwere 
obtain  e d 
from  the 
newspapers. 

Per  cent  of 
news  paper 
reports 

which  were 
confirmed  by 
the  health 
officer. 

Per  cent  of 
newspa  per 
reports 

wh  i c h were 
denied  by 
the  health 
officer. 

Per  cent  of 
new  spaper 
reports  to 
which  the 
health  officer 
made  no  reply 
to  notice  sent 
from  this  office. 

Diphtheria 

103 

12 

58 

0 

42 

Scarlet  fever _ 

108 

10 

27 

18 

55 

Typhoid  fever  ...  . 

127 

13 

38 

31 

31 

Measles 

54 

6 

33 

33 

33 

Averages  for  the  four  Diseases 

i 

1 

10  j 39  j 21 

40 

During  the  second  quarter  of  1890,  3,675  postal  cards,  and  245  record 
books  were  sent  to  245  health  officers  and  regular  correspondents;  the 
weekly  card-reports  received  were  entered  and  compiled;  42  copies  of  the 
hektographed  weekly  bulletin,  “Health  in  Michigan,”  were  mailed  each 
week;  79  copies  of  the  monthly  bulletin,  “Health  in  Michigan,”  and  121 
copies  of  the  diagram  of  “Comparative  Sickness, ’’^have  been  hektographed 
and  mailed  each  month. 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


These  bulletins  have  also  been  consolidated  for  the  quarterly  report 
made  today.  Work  has  been  done  on  the  compilation  of  the  weekly  card 
reports  of  sickness  for  the  Annual  Report. 

During  the  third  quarter  of  1890,  2,340  postal  cards  and  156  record  books 
were  sent  to  156  health  officers  and  regular  correspondents ; tKe  weekly  card 
reports  received  were  entered  and  compiled;  42  copies  of  the  weekly  bulletin, 
“Health  in  Michigan,”  were  hektographed  and  mailed  each  week;  80  copies 
of  the  monthly  bulletin,  “Health  in  Michigan,”  and  of  the  diagram  of 
“Comparative  Sickness,”  have  been  hektographed  and  mailed  each  month. 

These  bulletins  have  also  been  consolidated  for  the  quarterly  report 
made  today.  Work  has  been  done  on  the  compilation  of  the  weekly  card 
reports  of  sickness  for  the  Annual  Report. 

HEALTH  IN  MICHIGAN  IN  THE  SECOND  QUARTER  OF  1890. 

Communicable  Diseases. 

Compared  with  the  preceding  quarter  (January,  February  and  March, 
1890),  reports  from  all  sources  show  diphtheria  to  have  decreased  by  an 
average  of  two  places  per  month,  scarlet  fever  to  have  decreased  by  an 
average  of  fourteen  places  per  month,  typhoid  fever  to  have  decreased  by 
an  average  of  thirteen  places  per  month,  measles  to  have  increased  by  an 
average  of  thirty-seven  places  per  month  and  small-pox  to  have  decreased 
by  an  average  of  one  place  per  month,  disappeared  before  this  quarter 
began. 

Meteorology , and  Sickness  from  all  Causes,  Compared  with  the  Preceding  Quarter. 

A comparison  of  meteorological  conditions  of  the  second  quarter  of  1890, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
temperature  to  have  been  much  higher,  the  absolute  humidity  to  have  been 
considerably  more,  the  relative  humidity  to  have  been  slightly  less,  the  day 
and  the  night  ozone  to  have  been  more,  the  rainfall  at  Lansing  to  have 
been  2.53  inches  more  and  the  depth  of  ground  above  the  water  in  the  well 
at  Lansing  to  have  been  ten  inches  less  in  the  second  quarter  of  1890. 

Compared  with  the  preceding  quarter  (January,  February  and  March, 
1890),  the  reports  from  regular  observers  show  a marked  increase  of  cholera 
morbus,  typho-malarial  fever,  inflammation  of  brain,  measles,  dysentery, 
cholera  infantum  and  puerperal  fever,  and  a marked  decrease  of  small-pox, 
pneumonia,  influenza,  pleuritis  and  typhoid  fever  (enteric)  in  the  second 
quarter  of  1890. 

This  Quarter  Compared  with  the  Average  for  four  Years , 1886-1889.  (As  regidar 
rainfall  and  ground  water,  the  periods  are  different.) 

A comparison  of  the  meteorological  conditions  of  the  second  quarter  of 
1890,  with  the  average  of  corresponding  quarters  in  the  four  years,  1886- 
1889,  shows  that  in  1890,  the  temperature-  was  the  same,  the  absolute 
humidity  was  slightly  more,  the  relative  humidity  was  the  same,  the  day 
ozone  and  the  night  ozone  were  more. 

In  the  second  quarter  of  1890,  the  rainfall  at  Lansing  was  1.13  inches 
more  than  for  the  corresponding  quarters  in  the  eleven  years  1879-1889, 
and  the  depth  of  ground  above  the  water  in  the  well  at  Lansing,  was  ten 
inches  more  than  in  the  corresponding  quarters  in  the  five  years  1885-1889. 

Compared  with  the  average  for  the  corresponding  quarters  in  the  four 
years,  1886-1889,  the  reports  received  from  regular  observers  indicate  that 
membranous  croup,  measles  and  cholera  infantum  were  more  prevalent, 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  14,  1890. 


15 


and  that  typho-malarial  fever,  cholera  morbus,  typhoid  fever  (enteric)  and 
intermittent  fever  were  less  than  usually  prevalent  in  the  second  quarter  of 

1890. 

HEALTH  IN  MICHIGAN  IN  THE  THIRD  QUARTER  OF  1890. 

Communicable  Diseases. 

Compared  with  the  preceding  quarter  ( April,  May  and  June,  1890), 
reports  from  all  sources  showed  diphtheria  to  have  decreased  by  an  average 
of  six  places  per  month,  scarlet  fever  to  have  been  the  same,  typhoid  fever 
to  have  increased  by  an  average  of  thirty -one  places  per  month,  and 
measles  to  have  decreased  by  an  average  of  sixty -eight  places  per  month. 

Meteorology , and  Siekness  from  all  Causes,  Compared  with  the  Preceding  Quarter. 

A comparison  of  meteorological  conditions  of  the  third  quarter  of  1890, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
temperature  to  have  been  higher,  the  absolute  humidity  to  have  been  more, 
the  relative  humidity  to  have  been  slightly  more,  the  day  ozone  and  the 
night  ozone  to  have  been  less,  the  rainfall  at  Lansing  to  have  been  2.5 
inches  less,  and  the  depth  of  ground  above  the  water  in  the  well  at  Lansing 
to  have  been  one  inch  less,  in  the  third  quarter  of  1890. 

Compared  with  the  preceding  quarter  (April,  May  and  June,  1890),  the 
reports  from  regular  observers  show  a marked  increase  of  cholera  infantum, 
cholera  morbus,  dysentery,  typhoid  fever  (enteric),  diarrhea,  typho-mala- 
rial fever  and  inflammation  of  bowels,  and  a marked  decrease  of  membran- 
ous croup,  measles,  puerperal  fever,  pneumonia,  inflammation  of  brain, 
influenza,  remittent  fever  and  cerebro-spinal  meningitis,  in  the  third  quar- 
ter of  1890. 

This  Quarter  Compared  with  the  Average  for  the  Four  Years , 1886-1889.  (As  regards 
rainfall  and  ground  water  the  periods  are  different.) 

A comparison  of  the  meteorological  conditions  of  the  third  quarter  of 
1890,  with  the  average  of  corresponding  quarters  in  the  four  years,  1886- 
1889,  shows  that  in  1890,  the  temperature  was  slightly  lower,  the  absolute 
humidity  was  slightly  less,  the  relative  humidity  was  the  same,  the  day 
ozone  and  the  night  ozone  were  slightly  more  in  the  third  quarter  of  1890. 
j In  the  third  quarter  of  1890,  the  rainfall  at, Lansing  was  1.06  inches 
ess  than  for  the  corresponding  quarters  in  the  eleven  years,  1879-1889, 
and  the  depth  of  ground  above  the  water  in  the  well  at  Lansing  was  five 
inches  more  than  in  the  corresponding  quarters  in  the  five  years,  1885-1889. 

Compared  with  the  average  for  the  corresponding  quarters  in  the  four 
years,  1886-1889,  the  reports  received  from  regular  observers  indicate  that 
neuralgia,  measles,  influenza,  cerebro-spinal  meningitis  and  scarlet  fever 
were  more  prevalent,  and  that  puerperal  fever,  typho-malarial  fever,  inflam- 
mation of  brain,  whooping-cough  and  typhoid  fever  ( enteric ) Avere  less 
than  usually  prevalent  in  the  third  quarter  of  1890. 

Respectfully  submitted, 

Henry  B.  Baker, 

Secretary . 


:vT!  > filin’; 


0*1 


C®n.  Lib. 


Trit  LI3RARY  OF  illE 

JUN  25  1951 


ABSTRACT  OF  PROCEEDI^twStwwi i ur  illihuIS 


OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 

*« 


REGULAR  MEETING,  JULY  12,  1892. 


[185.] 

The  regular  quarterly  meeting  of  the  Michigan  State  Board  of  Health 
was  held  in  the  State  Capitol  in  Lansing,  July  12,  1892.  The  members 
present  were  as  follows:  Arthur  Hazle wood,  M.  D.,  Mason  W.  Gray,  M. 
D.,  Hon.  Frank  Wells,  and  Henry  B.  Baker,  M.  D.,  Secretary. 

The  usual  routine  work  was  performed.  There  was  also  the  usual 
auditing  of  bills  and  accounts. 

SYNOPSIS  OF  THE  SECRETARY’S  REPORT  OF  WORK  IN  THE  OFFICE  OF  THE  BOARD, 
AND  OF  THE  CONDITION  OF  HEALTH  IN  MICHIGAN  DURING 
THE  QUARTER  ENDING  JUNE  30,  1892. 

Dangerous  Communicable  Diseases. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  dis- 
eases in  Michigan,  received  from  all  sources  and  filed,  and  the  corre- 
sponding number  concerning  which  action  was  taken  by  this  office, 
during  the  quarter,  are  as  follows:  for  diphtheria,  140;  for  scarlet  fever, 
194;  for  typhoid  and  typho-malarial  fever,  54;  for  measles,  63.  Total  for 
the  five  diseases,  451. 

Small-pox  was  reported  in  two  localities  during  the  quarter;  one  case  in 
the  city  of  Detroit,  reported  April  25,  recovered,  no  spread  of  the  disease; 
one  case  in  Green  Oak  township,  Livingston  county,  reported  May  30, 
died;  no  spread  of  the  disease.  The  patient  was  an  immigrant,  who  landed 
at  Quebec,  from  a ship  which  was  supposed  to  be  infected  with  measles. 

The  number  of  communications  relative  to  dangerous  communicable 
diseases,  received  and  placed  on  file  during  the  quarter,  was  1,534. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and 
demands  for  weekly  or  final  reports,  on  cards,  or  in  the  form  of  the  cir- 
cular letter,  were  sent  out  during  the  quarter,  to  the  number  of  1,489. 

The  ‘‘Final  ” reports  of  outbreaks  received  and  filed  during  the  quarter, 
were:  for  diphtheria,  98;  scarlet  fever,  133;  typhoid  and  typho-malarial 
fever,  28;  measles,  15.  Total  for  the  five  diseases,  274. 

During  the  quarter,  the  local  columns  of  newspapers  to  the  number  or 
3,124,  have  been  looked  over  for  reports  of  occurrence  of  communicable 
diseases.  This  has  resulted  in  giving  this  office  information  of  the  alleged 
occurrence  of  12  outbreaks  of  diphtheria,  16  outbreaks  of  scarlet  fever,  11 
outbreaks  of  typhoid  and  typho-malarial  fever,  and  7 outbreaks  of  measles. 
To  what  extent  the  reports  of  these  alleged  outbreaks  were  verified,  is 
shown  in  the  accompanying  table. 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


TABLE  1. — Showing  the  number  of  Outbreaks  of  Diphtheria , Scarlet  fever , Typhoid 
fever  and  Measles,  from  April  30  to  June  30,  1892,  of  which  notice  was  received  at 
the  office  of  the  Michigan  State  Board  of  Health ; the  per  cent  of  reports,  informa- 
tion concerning  ichich  was  received  through  the  Newspapers ; the  per  cent  of  news- 
paper reports  which  were  confirmed  by  the  health  officer ; the  per  cent  of  newspaper 
reports  which  were  denied  by  the  health  officer,  and  the  per  cent  from  which  no  reply 
teas  received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources, 
April  30— June 
30,  1892. 

Per  cent  of  all 
reports  which 
were  obtained 
from  the  news- 
papers. 

Per  cent  of 
newspaper  re- 
ports which 
were  confirmed 
by  the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports which 
were  denied 
by  the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  health  offi- 
cer made  no 
reply  to  notice 
sent  from  this 
office. 

Diphtheria . 

140 

9 

58 

8 

33 

Scarlet  fever 

194 

8 

38 

13 

50 

Typhoid  fever 

54 

20 

0 

45 

55 

Measles 

63 

11 

43 

0 

57 

Averages  for  the  four  diseases 

12 

35 

17 

49 

Annual  Reports  of  Clerks  and  Health  Officers. 

Animal  reports  were  received  during  the  second  quarter  of  1892  from 
347  health  officers  and  414  clerks. 

On  May  20, 1892,  a ‘‘Third  Request  for  Annual  Report”  for  the  year  1891 
was  sent,  in  a sealed  envelope,  to  942  health  officers  and  clerks  from 
whom  no  report  had  been  received;  from  about  700  no  response  whatever 
has  been  received,  possibly,  in  some  cases,  owing  to  changes  made  at  the 
elections  held  in  March  and  April. 

Of  the  1,550  localities  in  the  State  including  cities,  and  villages,  the 
whole  number  of  annual  reports  for  the  year  1891  received  up  to  June  30, 
1892,  is:  from  health  officers  1,148,  and  clerks  1,152. 

Of  annual  reports  of  health  officers  and  clerks  combined,  800  have  not 
yet  been  received.  A large  number  of  the  localities  from  which  no  report 
has  been  received  are  in  the  newer  counties  and  recently  incorporated 
villages. 

The  annual  reports  received  for  the  year  1891,  have  been  arranged 
alphabetically  by  counties  and  townships  ready  for  compilation. 

Reports  of  Medical  Practitioners  in  their  localities,  were  received  dur- 
ing the  second  quarter,  from  93  clerks.  The  total  number  of  such  reports 
received  since  Jan.  1,  1892,  is  490. 

The  list  of  supervisors  and  clerks  for  the  year  1892,  supplied  by  the 
Secretary  of  State,  and  giving  nearly  complete  returns  for  85  counties,  has 
been  copied  for  use  in  this  office. 

Return  of  Health  Officers. 

Blanks  and  printed  envelopes  for  the  return  of  the  name  and  address  of 
health  officers  were  sent  to  2,493  supervisors  of  townships,  presidents  of 
villages,  mayors  of  cities,  and  clerks  of  cities,  villages  and  townships. 
The  returns  have  been  received  from  1,028  townships,  229  villages,  and  51 
cities,  and  have  been  placed  on  file  in  this  office. 

Distribution  of  Publications. 

The  following  pamphlets  were  sent  to  the  1,308  health  officers  of  cities, 
villages  and  townships  whose  names  were  reported  to  this  office,  and  to  the 
1,177  clerks,  supervisors,  or  other  persons  who  made  a return  of  the  name 
and  address  of  a health  officer:  “Work  of  Health  Officers  and  of  Local 


ABSTRACT  OP  PROCEEDINGS,  JULY  12,  1892. 


3 


Boards  of  Health”;  pamphlets  on  the  restriction  and  prevention  of 
diphtheria,  scarlet  fever,  typhoid  fever,  typhoid  and  typho-malarial  fever, 
measles;  the  leaflet  on  the  restriction  of  “Dangerous  Contagious  Diseases”; 
a blank  for  recording  diseases  dangerous  to  the  public  health,  blanks  for 
final  reports,  diagrams,  and  a mimeograph  letter  relative  to  a proposed 
change  in  the  law  so  that  only  health  officers,  instead  of  health  officers  and 
clerks,  shall  be  required  to  make  annual  reports  to  this  office. 

A copy  of  the  Public  Health  Laws  was  sent  to  each  of  the  521  new 
health  officers,  and  to  1,177  clerks,  supervisors,  or  other  persons  who  made 
a return  of  the  health  officer. 

The  reprint  from  the  Annual  Report  on  the  Time  of  the  Greatest  Pre- 
valence of  each  disease  in  Michigan  during  1889  was  sent  to  the  134 
physicians  who  made  sickness  reports  to  the  office. 

The  reprint  from  the  Annual  Report  on  the  Meteorological  Conditions 
in  Michigan  during  the  year  1889  was  sent  to  meteorological  observers, 
meteorological  exchanges,  and  to  the  members  of  this  board. 

About  900  copies  of  the  proceedings  of  the  Iron  Mountain  sanitary  con- 
vention were  sent  to  members  and  ex-members  of  this  Board,  secretaries  of 
State  Boards  of  Health,  secretaries  of  State  Medical  Societies,  sanitary 
journals  and  other  exchanges,  meteorological  observers  and  exchanges, 
members  of  the  State  Board  of  Corrections  and  Charities,  correspondents 
of  this  Board,  health  officers  of  cities  and  villages  in  Michigan,  presidents 
and  secretaries  of  previous  sanitary  conventions,  and  health  officers,  etc., 
in  other  states. 

Compiling , Editing,  etc.,  for  Publication. 

During  the  quarter  the  reports  from  health  officers  and  clerks  have  been 
compiled,  and  the  articles  have  been  written  on  the  following  subjects,  for 
the  Annual  Report:  Glanders,  tyrotoxicon,  hydrophobia,  whooping-cough, 
epidemic  pneumonia,  casualties  from  gasoline,  and  injuries  caused  by 
illuminating  oils;  work  on  the  article  on  typhoid  fever  has  been  continued; 
considerable  work  has  been  done  on  the  first  part  of  the  report,  and  the 
indexing  has  been  commenced. 

Library  Accessions,  etc. 

During  the  second  quarter  of  1892  three  hundred  and  eighty-seven 
(387)  journals  (weeklies,  monthlies,  and  semi-monthlies)  were  received  at 
this  office;  and  sixty-eight  (68)  books  and  pamphlets  were  received  and 
entered  on  the  library  accession  book,  making  the  total  number  of  books 
and  pamphlets  (not  including  volumes  of  journals  not  yet  bound)  con- 
tained in  the  library  8,229. 

Work  on  Meteorology. 

The  regular  tri-daily  meteorological  observations  have  been  continued 
at  this  station,  and  a summary  for  each  week  and  month  during  the  quar- 
ter has  been  made,  and  copies  sent  to  the  director  of  the  Michigan  State 
Weather  Service  and  local  forecast  official  at  Detroit  for  his  use;  he  then 
sends  them  to  the  chief  of  the  Weather  Bureau,  at  Washington,  D.  C. 

Meteorological  conditions  at  from  8 to  22  stations  in  Michigan  for  1891 
have  been  tabulated  as  follows:  Average  temperature,  average  daily  range 
of  temperature,  average  absolute  humidity,  average  relative  humidity, 
average  per  cent  of  cloudiness,  rainfall,  average  velocity  of  the  wind,  aver- 
age day  ozone,  average  night  ozone,  average  atmospheric  pressure,  and 
average  daily  range  of  atmospheric  pressure.  Computations  of  average 
temperature,  average  per  cent  cloudiness,  direction  of  wind,  average  day 
and  night  ozone,  average  daily  range  of  temperature,  and  rainfall  have 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


been  made  from  meteorological  registers  at  from  15  to  21  stations  for  the 
first  five  months  of  1892. 

Graphic  Illustrations , for  Study , Publication,  or  Distribution. 

Eight  diagrams  have  been  made  with  photo-engraving  ink  for  purposes 
of  study  or  for  publication  by  the  Board,  as  follows: — 

“Relations  of  Privies  and  Wells,  Block  36,  Holland,  Mich.” 

“ Scarlet  Fever  in  Michigan  in  1889.” 

“Low  Water  in  Wells  and  Sickness  from  Typhoid  Fever  in  Michigan 
(11  years,  1878  and  1880-89).” 

“ Fog  and  Sickness  from  Typhoid  Fever  in  Michigan,  in  1889.” 

“ Low  Water  at  Lansing  and  Typhoid  Fever  in  Michigan,  in  1889.” 

“ Diseases  Restricted  by  Public-Health  Work.” 

“Map,  Distribution  of  Scarlet  Fever  in  Michigan  in  1889.” 

Diagram,  51x33  inches,  on  cloth, — “Isolation  and  Disinfection  Res- 
tricted Scarlet  Fever  and  Diphtheria  in  Michigan  during  the  4 years 
1886-89.” 

Five  diagrams  have  been  made  with  hektograph  ink,  and  copies  printed 
for  distribution. 

Meteorological  instruments  have  been  entrusted  to  observers  during  the 
quarter, — to  J.  W.  Ash,  Ashton,  Osceola  Co.,  to  Lieut  A.  H.  Boies,  Hud- 
son, Michigan,  and  to  W.  C.  Gates,  M.  D.,  Rockland,  Michigan. 

Work  in  Connection  with  Sickness  Statistics. 

During  the  second  quarter  of  1892,  3,612  blank  postal  cards,  241  record 
books  and  251  copies  of  printed  circulars  have  been  mailed  in  packages  to 
241  health  officers  and  regular  correspondents;  1,158  weekly  report  cards 
have  been  received  and  entered;  43  copies  of  the  hektographed  weekly 
bulletin  “Health  in  Michigan,”  were  mailed  each  week;  100  copies  of 
the  monthly  bulletin  “ Health  in  Michigan,”  have  been  hektographed  and 
mailed  each  month.  These  bulletins  have  also  been  consolidated  for  the 
quarterly  report.  Work  has  also  been  done  on  the  compilation  of  the 
weekly  card  reports  of  sickness  during  the  year  1890  for  the  annual  report. 

The  Weather  and  the  Health  in  Michigan  in  the  second  quarter  of  1892,  compared 
with  the  average  for  the  six  years  1886-1891. 

A comparison  of  the  meteorological  conditions  of  the  second  quarter  of 
1892,  with  the  average  for  the  second  quarters  in  the  six  years,  1886-1891, 
shows  that  in  1892,  the  prevailing  direction  of  the  wind  was  the  same 
(south-west),  the  average  velocity  was  greater,  the  temperature  was  slightly 
lower,  the  rain-fall  at  Lansing  was  1.87  inches  more,  the  absolute,  and  the 
relative  humidity  were  slightly  more,  the  day,  and  the  night  ozone  were 
considerably  less  and  the  depth  of  ground  above  the  water  in  the  well  at 
Lansing  was  nine  inches  more  than  in  the  corresponding  quarters  in  the 
six  years  1886-1891.  Compared  with  the  average  in  the  corresponding 
quarters  in  the  six  years  1886-1891,  the  reports  received  from  regular 
observers  indicate  that  small-pox,  diphtheria  and  scarlet  fever  were  more 
prevalent,  and  that  measles,  typho-malarial  fever,  intermittent  fever, 
cerebro-spinal  meningitis,  whooping-cough,  remittent  fever,  consumption 
of  lungs  and  typhoid  fever  were  less  than  usually  prevalent  in  the  second 
quarter  of  1892. 

Cholera. 

Relative  to  the  reported  presence  of  cholera  in  foreign  countries,  and 
the  possibility  of  its  being  brought  to  this  country,  Secretary  Baker 
remarked  that  it  would  be  a particularly  unfortunate  time  if  cholera 
should  soon  reach  Chicago  or  Detroit,  because  it  tends  to  spread  in  much 


ABSTRACT  OF  PROCEEDINGS,  JULY  12,  1892. 


5 


the  same  ways  as  typhoid  fever,  only  with  much  greater  rapidity,  and 
typhoid  fever  is  unusually  prevalent  in  Chicago,  and  appears  to  have  been 
increasing  lately  in  Detroit.  If  cholera  should  gain  entrance  to  either 
city,  so  many  of  our  people  visit  those  cities  that  we  might  soon  find  chol- 
era spread  in  many  places  throughout  Michigan.  This  office  is  prepared 
to  issue  circulars,  already  printed,  advising  local  health  officers  just  how 
to  restrict  cholera. 

Contagious  Diseases  Brought  in  by  Immigrants. 

The  Secretary  presented  the  subject  of  infected  immigrants,  and,  to 
illustrate  a point,  read  a letter  from  a township  health  officer,  stating  that 
he  had  found,  isolated  and  vaccinated  the  person  of  whom  he  was  notified 
as  possibly  infected  with  small-pox,  also  reporting  his  action  concerning 
one  of  the  immigrants,  of  whom  he  had  received  notice,  who  had  come 
down  with  measles.  The  expense  incident  to  these  cases  was  about  $17. 
He  thought  the  national  government  might  go  a step  further  and  detain 
at  the  seaboard  those  immigrants  likely  to  be  infected. 

Sanitary  Subjects  at  the  meeting  of  the  American  Medical  Association  in  Detroit , 
June  7-11 , 1892.  Report  of  Attendance  by  Delegates. 

Dr.  Hazlewood  reported  verbally  that  “The  notable  features  of  the 
meeting  of  the  American  Medical  Association  in  Detroit,  were  the  large 
attendance,  the  good  accomodations  for  the  meetings  of  sections  as  well  as 
for  the  general  meetings;  the  meetings  for  work  of  the  sections  morning 
and  afternoon,  and  the  prominence  given  to  subjects  having  a bearing  upon 
preventive  medicine,  not  confined  to  the  section  on  State  Medicine.  The 
section  on  Diseases  of  Children  virtually  gave  up  two  morning  sessions  to 
a discussion  of  the  prevention  of  diphtheria  and  scarlet  fever.  Dr.  Duf- 
field  there  explained  the  difficulties  incident  to  carrying  out  any  plan  of 
isolation  in  the  homes  of  the  poor,  when  the  family  had  no  spare  room,  and 
the  mother  was  unaided  in  any  of  her  domestic  duties,  and  often  tenants 
only  of  premises  occupied  in  part  by  other  families  equally  restricted  in 
space  or  assistants.  Dr.  Duffield  outlined  a scheme  for  Cottage  Hospitals 
which  he  had  presented  to  the  Common  Council  in  which  provision  would 
be  made  for  the  removal  of  all  cases  of  contagious  disease,  together  with 
the  mother  of  the  child,  where  all  precaution  could  be  taken  and  the 
patient  would  be  better  placed  than  in  any  ordinary  home. 

“With  so  many  sections  holding  sessions  at  the  same  time  it  was  impos- 
sible to  get  in  to  all  that  was  of  interest  to  the  sanitarian.  ,At  the  after- 
noon session  on  Wednesday  of  the  State  Medical  section,  Dr.  Bell  of 
Brooklyn  read  an  interesting  article  advocating  a National  Bureau  of  Health 
in  which  he  cited  some  of  his  own  experiences  and  the  good  results  from 
steaming  the  holds  of  vessels  that  have  been  infected  with  yellow  fever. 
Dr.  Harvey  Reed  advocated  more  inspection  of  the  slaughter  houses,  and 
meat  there  prepared  for  food,  and  asked  for  a committee.  Dr.  Gihon  pro- 
tested that  the  U.  S.  government  inspection  was  complete  and  asked  how 
the  committee  were  to  be  compensated.  Dr.  Reed  answered  that  the 
expense  was  not  to  be  considered;  that  a committee  could  be  formed  of 
members,  residents  near  the  large  slaughter  houses,  and  he  thought  good 
would  come  of  it.  On  his  representation  the  committee  was  authorized  by 
a vote  of  13  to  5.  The  number  in  attendance  was  an  evidence  also  of  the 
interest  in  this  section. 

“Thursday  afternoon  the  section  on  State  Medicine  was  not  quite  so 
well  attended.  The  sanitary  side  of  the  drinking  question  was  presented, 
and  the  view  that  the  habit  should  be  considered  as  a disease  was  empha- 
sized. Dr.  Bell  cited  a case  of  his  own  experience  on  board  ship,*  where  a 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


youthful  sailor  was  whipped  for  drunkenness  with  good  effect.  The  general 
opinion  as  expressed  however  was,  that  the  confirmed  drinker  should  be 
treated  as  an  insane  person  and  protected  in  a hospital. 

“The  river  excursion  cut  short  the  arguments,  and  the  section  adjourned 
after  electing  Dr.  Charles  A.  Lindsley,  of  Conn.,  chairman,  and  Dr.  S.  P. 
Duffield,  of  Detroit,  secretary. 

“Friday  morning  several  of  the  sections  either  failed  to  meet  or  had 
already  adjourned  so  that  I found  nothing  of  special  importance  in  a sani- 
tary point  of  view,  until  the  hour  for  the  general  session  which  closed 
with  the  masterly  address  on  State  Medicine  by  Dr.  J.  Berrien  Lindsley, 
of  Tenn.,  and  finished  the  work  of  the  Association,  and  of  which  I can  only 
refer  you  to  the  published  copy  in  the  Journal  of  the  Association. 

Dr.  Mason  W.  Gray  reported  verbally  as  a delegate  to  the  meeting  of  the 
American  Medical  Association:  The  section  on  preventive  medicine  was 
largely  attended;  and  public-health  work  was  given  a prominent  part  in 
the  meeting  of  the  association.  Dr.  Hazlewood  neglected  to  state  that, 
in  the  section  on  State  Medicine,  he  and  Dr.  Vaughan  took  prominent  part 
in  the  discussion  of  the  contagiousness  of  scarlet  fever.  An  interesting 
fact  was  mentioned  by  Dr.  Brush,  from  Mt.  Pleasant,  N.  Y.,  that  the 
source  of  contagion  in  a case  of  scarlet  fever  had  been  traced  to 
clothing  infected  with  scarlet  fever  which  had  been  opened  after  being 
packed  away  for  thirty-five  years.  Dr.  J.  Berrien  Lindsley  of  Tennessee, 
gave  a very  fine  address  on  State  Medicine,  and  Dr.  Gihon,  in  his  address 
on  the  Practice  of  Medicine,  gave  much  of  interest  to  the  sanitarian.  I 
was  agreeably  surprised  to  see  that  preventive  medicine  took  such  a prom- 
inent part  in  the  association,  and  in  the  discussions  in  the  several  sections, 
and  that  the  subject  is  being  given  more  and  more  prominence  in  the 
affairs  of  medical  men. 


A Sanitary  Day. 

Dr.  Hazlewood  brought  up  the  subject  of  a “ Sanitary  Day,”  concern- 
ing which,  since  the  last  meeting,  there  has  been  correspondence  with 
members  of  this  Board  by  the  Secretary.  Dr.  Hazlewood  thought  that 
the  subject  was  worthy  of  action,  and  that  it  should  be  brought  into  pub- 
lic notice  as  soon  as  practicable.  The  subject  was  discussed  by  the  mem- 
bers present.  The  health  interests  suffer  because  they  are  not  supported 
by  the  people;  it  is  believed  that  they  would  be  properly  supported  if 
facts  were  carefully  put  before  the  people  every  year  at  a sanitary  meet- 
ing similar  to  the  school  meeting  in  September. 

The  origin  and  nature  of  the  movement  may  be  learned  from  what  here 
follows : — 

Dr.  Joseph  F.  Edwards,  chairman  of  a special  committee  of  the  Penn- 
sylvania State  Board  of  Health  on  this  subject,  wrote  to  the  Secretary  of 
the  Michigan  Board,  stating  that  “ It  has  been  suggested  to  our  board  by 
the  mayor  of  one  of  our  cities,  that  we  should  recommend  to  our  legisla- 
ture the  setting  apart  of  two  days  annually,  one  in  the  Spring,  the  other 
in  the  Fall,  to  be  known  as  ‘Sanitary  Days;’  these  days  to  be  devoted, 
in  an  especial  manner,  to  domestic  and  municipal  ‘ cleaning  up.’  ” * * * 
“As  we  have  Labor,  Arbor  and  Independence  days,  with  their  appropriate 
celebrations,  so  might  we  also  have  Sanitary  Days,  on  which,  in  each 
town  and  village  special  instruction  in  hygiene  might  be  given  to  the 
people.” 

The  Secretary  of  the  Michigan  Board  replied: 

“ Dear  Doctor— Replying  to  your  letter  of  June  18, 1 think  the  suggestion  for  a ‘ Sanitary  Day’  to  be- 
devoted  to  public  health  subjects  a very  important  suggestion.  * * * * 


ABSTRACT  OF  PROCEEDINGS,  JULY  12,  1892. 


7 


“ However,  cleanliness  and  ‘ cleaning  up  ’ are  of  minor  importance,  compared  with  the  restriction  and 
pievention  of  the  dangerous  communicable  dieseases ; these  are  the  diseases  which  cause  most  deaths  in 
Pennsylvania,  as  in  Michigan.  I enclose  a diagram  showing  the  five  diseases  which  cause  most  deaths  in 
Michigan.  You  will  see  that  only  one  of  the  five  (typhoid  fever)  is  due  to  filth,  and  can  be  very  much 
restricted  by  ordinary  cleanliness. 

“ Four  of  the  five  diseases  which  cause  most  deaths  in  Michigan  are  increased  during  or  following  the 
cold  weather;  and  the  remaining  one,  typhoid  fever,  reaches  its  highest  point  in  October.  I think  the 
Sanitary  day  should  be  in  the  autumn. 

“ In  reply  to  your  request  for  suggestion  for  the  proper  observance  of  the  day,  I send  you,  by  this  mail 
a copy  of  the  Journal  of  the  American  Medical  Association,  of  May  21,  1892,  on  the  first  two  pages  of 
which  is  an  article  by  myself  on  this  subject,  proposing  the  setting  apart  by  law  of  a day  in  each  year  on 
which  to  present  locally  to  the  people  of  every  township,  city  and  village,  the  facts  and  reasons  why 
expenditures  for  public-health  work  are  in  the  public  interests;  the  purpose  being  the  appropriation  of 
money  for  public-health  work.  But  there  would  be  very  much  besides  the  appropriation  of  money,  to  be 
gained  through  such  a systematic  presentation  of  sanitary  affairs  throughout  the  country  on  such  a day 
set  apart  in  each  year. 

“ I agree  with  you  that  spasmodic  action  on  one  or  two  days  in  a year  is  not  enough;  but,  if  proper 
work  is  done  on  this  one  day  proposed,  I think  it  would  be  one  of  the  most  important  measures  for  the 
advancement  of  public  health  that  has  ever  been  proposed  in  this  country.  I wish  the  movement  great 
success.  Very  respectfully, 

HENRY  B.  BAKER,  Secretary." 

The  article  referred  to  in  the  forgoing  letter  was  the  annual  oration  on 
i general  medicine  before  the  Michigan  State  Medical  Society,  in  May,  1892. 
It  is  as  follows: 

THE  WORK  AND  PAY  OP  HEALTH  OFFICERS. 

(Published  by  permission  of  the  Michigan  State  Medical  Society.) 

BY  HENRY  B.  BAKER,  M.  D.,  OF  LANSING,  MICH. 

Mr.  President  and  Members  of  the  State  Medical  Society : — I wish,  first 
of  all,  to  thank  the  section  of  Practice  of  Medicine  for  this  opportunity  to 
place  before  you  what  I have  to  offer.  I have  assumed  that  I would  be 
expected  to  deal  with  some  subject  likely  to  be  of  interest  to  the  general 
practitioners,  and  which  my  own  occupation  might  enable  me  to  have  more 
than  ordinary  opportunities  for  studying.  Inasmuch  as  the  State  law 
now  requires  that,  wherever  it  is  practicable,  every  health  officer  shall  be 
a physician,  and  there  are  now  fifteen  hundred  health  officers  chosen  in 
Michigan  every  year,  there  is  a posibility  of  my  subject  being  of  interest 
to  a considerable  proportion  of  the  general  practitioners  in  the  State,  be- 
cause many  of  them  may,  at  some  time,  be  health  officers,  and  because,  if 
my  views  were  to  be  carried  out,  nearly  fifteen  hundred  practitioners  would 
devote  the  greater  part  of  their  energies  to  official  duties,  and  not  to  the 
practice  of  medicine. 

Although  the  title  of  this  address  is  “The  Work  and  Pay  of  Health 
Officers,”  I desire,  at  this  time,  to  deal  especially  with  the  subject  of  pay. 
My  belief  is  that  the  compensation  of  the  health  officers,  generally 
throughout  the  State,  with  only  a few  exceptions,  is  ridiculously  small 
and  inadequate;  and  that  the  best  interests  of  all  concerned  are  injured 
thereby,  and  will  be  best  conserved  by  such  a general  change  as  shall 
recognize  the  fact,  as  old  as  the  scriptures,  that  “the  laborer  is  worthy  of 
his  hire”  or  reward.1  I suppose  it  is  not  necessary  for  me  to  laboriously 
prove  that  this  proposed  change  would  be  a good  thing  for  the  medical 
profession  in  this  State;  if  it  is  ever  questioned  I will  try  to  prove  it,  on 
some  other  occasion;  but  it  may  not,  at  first  glance,  be  so  apparent  that 
it  would  be  a good  thing  for  the  sanitary  interests  of  the  whole  people  of 
the  State.  Therefore  the  reasons  for  a belief  that  such  is  the  fact  may 
well  be  stated. 


1 1 Timothy,  v.  18,  and  Luke  x.  7. 


s 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


At  first  thought,  it  might  seem  that  gratuitous  services  by  physicians 
acting  as  health  officers  would  always  be  for  the  best  interests  of  the 
people  generally;  and,  in  the  beginning  of  any  movement  for  sanitary  re- 
form, it  undoubtedly  is  for  the  best  interests  of  the  people.  The  people 
of  Michigan  owe  a great  debt  of  gratitude  to  the  philanthropic  physicians 
throughout  this  State  who  have  generously  performed  services  for  the 
public  which  the  people  generally  were  not  sufficiently  informed  to  ask  for, 
to  pay  for,  or  to  appreciate,  but  which  have  tended  to  place  Michigan  in 
the  front  rank  of  progress  in  sanitary  reform.  The  officers  and  members 
of  this  State  Medical  Society,  especially,  have  contributed  very  greatly  to 
place  Michigan  in  the  lead  in  sanitary  progress. 

But,  in  the  evolution  of  organized  society,  there  come  times  when 
methods,  which  have  served  exceedingly  useful  purposes,  need  to  undergo 
slight  modification  in  order  better  to  fit  them  for  the  changed  conditions. 
In  my  opinion,  the  time  has  arrived  when  it  will  best  serve  the  people  of 
Michigan  to  gradually  educate  them  into  a knowledge  of  the  real  value  of 
public-health  work,  and  into  an  appreciation  of  the  fact  that  it  is  best  for 
corporations  and  governments,  townships,  cities  and  villages,  as  it  has  long 
been  known  to  be  best  for  individuals,  not  to  try  to  get  something  for 
nothing.  In  the  long  run,  an  effort  to  get  something  for  nothing  is  un- 
successful. Such  efforts  generally  lead  the  individual  to  the  penitentiary, 
and  the  government  to  a penitential  mood. 

The  people  have  gradually  so  increased  in  appreciation  of  the  impor- 
tance of  public-health  work  that  their  representatives,  the  law-makers, 
have  provided  so  much  work  to  be  done  by  health  officers,  and  have  affixed 
to  the  non-performance  of  the  duties  such  penalties  that  no  ordinary 
practitioner  can  without  adequate  compensation  afford  to  take  the  chances 
of  being  held  accountable  under  the  law  for  the  neglect  of  official  duty. 
But  the  main  reason  why  it  does  not  now  seem  to  be  best  that  the  duties 
of  the  health  officer  should  generally  be  performed  gratuitously,  is  that 
no  ordinary  practitioner  can  afford  to,  and  it  is  getting  so  that  generally  no 
competent  physician  will,  for  any  small  sum,  neglect  his  practice  and  do 
all  that  the  law  and  public  sentiment  now  expect  to  be  done  by  the  health 
officer. 

The  amount  of  service  that  is  now  required  of  the  health  officer  is 
frequently  not  appreciated  by  the  physician  until  he  has  accepted  the 
office,  when  he  finds  that,  owing  to  comparatively  recent  laws,  more  is  re- 
quired of  him  than  he  anticipated. 

What  is  needed  is  some  method  whereby  not  only  physicians,  but  the 
people  generally,  who  have  to  pay  the  health  officer,  shall  become  informed 
of  the  nature,  extent,  and  importance  of  the  work  of  the  health  officer. 
It  seems  to  me  that,  as  might  have  been  expected  from  the  occupation, 
those  who  have  managed  the  school  interests  in  Michigan  have  shown 
most  wisdom  in  their  methods  of  impressing  the  people  with  the  impor- 
tance of  their  work,  and  also  in  obtaining  from  the  people  the  necessary 
money  to  carry  on  the  school  work.  We  need  to  adopt  their  methods. 
Whoever  will  examine  his  receipt  for  taxes  will  find  that  the  main  items  are 
for  school  purposes.  Yet  the  people  vote  to  assess  themselves  for  those 
purposes,  after  the  subject  has  been  carefully  put  before  them.  And  those 
who  have  the  interests  of  the  schools  in  charge  have  opportunity,  and  they 
carefully  prepare  and  put  before  the  people  every  year,  at  the  school 
meeting  in  September,  the  amounts  of  money  which  is  estimated  should 
be  used  for  school  purposes,  and  facts  and  reasons  why  those  amounts  are 
needed.  There  should  be  a law  similar  to  the  school  law,  relative  to 


ABSTRACT  OF  PROCEEDINGS,  JULY  12,  1892. 


9 


public-health  affairs.  Surely  the  interests  of  the  health  and  life  of  the 
whole  people,  including  the  children,  are  of  more  consequence  than  the 
ischool  education  of  the  children  alone! 

All  that  is  required  to  make  this  apparent,  is  such  an  opportunity  as  the 
school  laws  provide  for  placing  the  facts  before  the  people  at  the  time  the 
vote  is  taken  to  adopt  the  estimates  of  those  who  have  this  branch  of  the 
public  service  in  charge. 

How  to  get  Money  for  Public  Health  Work. — Have  a public  meeting  of 
citizens  of  the  city,  village  or  township,  at  which  meeting  the  amount  of 
money  to  be  assessed  and  collected  for  public-health  purposes  shall  be 
voted  upon.  Have  the  local  board  of  health  present  to  that  meeting  esti- 
mates of  the  amounts  proper  to  be  collected.  The  health  officer  should 
be  prepared,  and  should  present  to  this  public  meeting  the  facts,  and  rea- 
sons why  expenditures  for  public-health  work  are  in  the  public  interests.  It 
ought  not  to  be  difficult  to  convince  the  people  generally  that  the  lives 
and  health  of  the  people  themselves  are  of  more  consequence  than  any 
other  subject  for  which  they  collect  taxes. 

Let  us  suppose  that  opportunity  is  given  the  health  officer  to  put  before 
•the  people  of  a township,  village  or  city  the  facts  and  reasons  for  public- 
health  work;  what  can  be  presented?  This  can  be  presented: — 

1.  The  health  officer  can  assure  the  people  that,  if  they  are  situated  in 
the  average  locality  in  Michigan,  the  death-rate  will  average  about  17  per 
thousand  inhabitants  per  year;  that,  of  those  deaths,  about  11.8  per  cent, 
will  be  from  consumption,  6.5  from  diphtheria,  2.7  from  scarlet  fever,  and 
3.2  from  typhoid  fever.  He  can  assure  the  people  that  these  are  all  com- 
municable diseases,  that  they  are  all  preventable  through  measures  which 
are  now  well  known  to  sanitarians;  and,  what  is  more  to  the  point,  he  can 
assure  them  that  reliable  statistics,  collected  by  the  Michigan  State  Board 
of  Health,  from  the  experience  of  local  officers  in  Michigan,  have  proved 
that  (even  after  the  disease  has  been  introduced)  about  75  or  80  per  cent 
of  the  cases  and  deaths  from  diphtheria  and  from  scarlet  fever  are  pre- 
vented by  measures  which  a good  health  officer,  acting  in  accordance 
with  our  present  laws,  and  supported  by  the  people  of  his  locality,  can 
inaugurate  and  maintain.  Knowing  approximately  the  population  of  the 
township,  village  or  city,  the  health  officer  can  readily  compute  the 
saving  of  life  which  such  a saving,  as  has  been  proved  to  occur  under 
such  measures,  would  be  for  that  number  of  inhabitants.  Let  us  suppose 
a small  city,  of  four  thousand  inhabitants — then  the  deaths  from  all 
causes,  at  the  rate  of  17  per  thousand  per  year,  would  be  68;  the  deaths 
from  consumption  (11.8  per  cent.)  would  be  8;  the  deaths  from  diph- 
theria (6.5  per  cent.)  would  be  about  4-|  (4.4);  the  deaths  from  scarlet 
fever  (2.7  per  cent.)  would  be  nearly  two  (1.8);  the  deaths  from  typhoid 
fever  (3.2  per  cent.)  would  be  a little  over  two.  If  75  per  cent,  of  these 
deaths  were  to  be  prevented,  there  wrould  be  a saving  of  the  lives  of  about 
three  persons  from  death  by  diphtheria,  about  one  from  scarlet  fever,  and 
one  from  typhoid  fever.  These  five  persons  constitute  a part  of  the  pro- 
ductive energy  of  the  city  upon  which  its  prosperity  depends.  They  are 
worth  to  the  city,  for  what  has  been  expended  to  raise  them,  and  for  what 
they  will  earn  in  excess  of  costs  of  maintenance,  at  least  as  much  each 
as  a good  slave  would  sell  for  before  the  war,  which  was  about  the  same  as 
the  statisticians  compute  as  the  value  of  an  ordinary  laborer — say  for  the 
•adult  person  one  thousand  dollars,  and  for  each  of  the  children  one-  half 
of  that  .amount.  The  four  who  are  saved  from  diphtheria  and  scarlet 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


fever  would  be  likely  to  be  children,  while  the  one  saved  from  typhoid 
fever  would  be  likely  to  be  in  the  prime  of  life.  The  actual  money  value 
of  the  five  persons,  therefore,  would  be  three  thousand  dollars.  If  a city 
of  four  thousand  inhabitants  should  vote  to  use  three  thousand  dollars 
per  year  in  public-health  work,  I have  no  doubt  whatever  but  the  five  lives, 
above  mentioned,  could  be  saved,  from  those  three  diseases  alone;  and 
probably  lives  could  be  saved  from  other  diseases.  Then  how  much 
better  to  save  those  lives,  and  avoid  the  grief  and  sorrow  which  would 
result  from  their  loss.  Again,  the  money  used  would  be  only  the  amount 
which,  without  effort  for  restriction,  would  be  lost  to  the  city — the  actual 
outlay  would  not  be  at  all  increased.  It  seems  to  me  that  any  meeting  of 
citizens,  of  ordinary  intelligence,  could  be  made  to  see  that  the  lack  of 
public  health  work  is  a wasteful  extravagance,  and  that  it  is  better  to  use 
a certain  sum  of  money  to  pay  a health  officer  than  to  permit  the  death  of 
loved  ones  that  have  actually  cost  as  much  as  that  sum,  and  who,  if  they 
die,  are  a dead  loss,  in  more  than  one  sense. 

These  facts  are  applicable  to  every  locality  in  Michigan,  making  allow- 
ance for  a greater  or  less  number  of  Inhabitants.  ***** 

I have  given  you  some  of  the  reasons  why  I favor  legal  provision  for  the 
presentation  locally,  to  all  voters  throughout  the  State,  of  the  benefits  to 
be  expected  from  sanitary  work,  after  the  manner  of  the  meetings  to  de- 
termine the  amounts  of  money  to  be  raised  for  school  purposes. 

Abstract  of  the  Proceedings  of  the  Special  Committee  Meeting , at  the  Russell  Houser 

Detroit , Mich..  April  28,  1892. 

The  committee  of  the  State  Board  of  Health  met  in  Detroit  in  accordance  with  the  following  resolution  t 

Resolved , That  a committee,  consisting  of  the  president  and  four  other  members  of  this  Board,  be 
appointed  to  visit  Detroit,  and  confer  with  the  health  officer  and  with  the  board  of  health  of  Detroit  and 
with  other  city  officers  if  found  desirable,  with  the  view  of  learning  and  of  reporting  to  this  Board,  so  much 
as  is  possible  concerning  the  difficulties  under  which  the  Detroit  officers  are  laboring  for  the  restriction 
and  prevention  of  the  dangerous  diseases. 

The  meeting  was  called  to  order  at  2:00  P.  M.  by  chairman  John  Avery,  M.  D.,  of  Greenville.  The 
members  present  were:  Hon.  John  Avery,  M.  D.,  Victor  C.  Vaughan,  M.  D.,  and  Arthur  Hazlewood,  M.  D.. 
Mason  W.  Gray,  M.  D.,  was  delayed  in  coming  and  arrived  about  3:00  P.  M.,  and  Henry  B.  Baker,  M.  D.,. 
was  sick  and  could  not  attend. 

The  following  named  persons  attended  the  meeting:  Hon.  Hazen  S.  Pingree,  mayor  of  the  city,  John 
McVicar,  president  of  the  Board  of  Public  Works,  Samuel  P.  Duffield,  M.  D.,  health  officer  of  the  city, 
Drs.  J.  E.  Clark,  C.  J.  Lundy,  J.  H.  Carstens,  C.  W.  Hitchcock,  H.  O.  Walker,  H.  F.  Lyster,  C.  G.  Jen- 
nings, W.  C.  Stevens,  L.  J.  Lenox,  G.  E.  Roehrig,  and  Mrs.  Lemkie  of  546  Fifteenth  Street. 

Dr.  Vaughan  said  that  the  Board  called  this  meeting  because  they  believed  that  scarlet  fever  and  diph- 
theria were  uncommonly  prevalent  in  Detroit,  and  they  would  like  to  find  out,  if  possible,  the  difficulties 
under  which  the  Detroit  officers  were  laboring  in  the  restriction  and  prevention  of  the  dangerous  diseases;, 
and  they  came  with  the  idea  of  aiding,  if  they  could,  in  the  restriction  of  these  diseases,  and  were  not 
there  for  the  purpose  of  criticising  the  Detroit  Board. 

Dr.  Vaughan  read  a comparison  of  the  cases  and  deaths  from  diphtheria  and  scarlet  fever  in  Detroit 
with  the  State  of  Michigan  for  1888,  and  in  Detroit  compared  with  New  York,  Chicago,  and  some  other 
cities  of  the  United  States  for  the  month  of  March,  1892.  A hektographed  copy  of  these  comparisons  was 
given  to  each  person  present. 

Dr.  Duffield  said— We  have  many  men  in  Detroit,  who  are  dependent  upon  their  daily  work  for  the 
support  of  their  families.  When  a child  of  one  of  these  families  is  taken  with  scarlet  fever,  we  cannot 
lock  up  the  whole  family  including  the  father,  in  an  attempt  at  isolation ; yet  Secretary  Baker  seems  to 
insist  that  we  should  isolate  the  whole  family  by  just  that  sort  of  method.*  The  Detroit  Board  of  Health 
has,  hitherto,  had  very  little  cooperation  with,  and  support  from,  the  city  authorities.  If  we  were  to 
attempt  the  perfect  isolation  of  these  cases,  just  see  how  impossible  it  would  be.  There  were  last  year 
1,359  cases,  an  average  of  136  per  month.  Each  case  would  require  three  police,  each  standing  guard  eight 
hours,  or  408  policemen  to  isolate  these  cases,  which  is  more  than  the  whole  number  of  policemen,  which 
now  cost  $500,000. 

* TNo.  Dr.  Baker  wants  the  State  law  complied  with,  and  in  that  there  is  no  authority  for  locking  up 
anybody,  except  after  conviction  by  a court.  It  requires  the  health  office?  to  order  isolation.  H.  B.  B.} 


ABSTRACT  OF  PROCEEDINGS,  JULY  12,  1892. 


11 


Suppose  you  isolated  the  first  cases,  said  Dr.  Vaughan,  you  would  not  have  had  so  many;  and  you  are 
going  to  have  more  next  year,  as  they  will  all  the  time  increase. 

Dr.  Duffield  said  that  there  is  no  doubt  that  would  lessen  the  number  of  cases,  but  that  it  was  just 
impossible  for  them  to  have  perfect  isolation,  for  reasons  he  had  just  stated.  If  we  were  to  lock  these 
families  up,  there  would  immediately  be  a habeas  corpus  taken  out.  We  asked  for  $10,000  for  contagious- 
disease-isolation-hospitals,  and  could  not  get  it.  The  poor  fund  is  exhausted,  and  the  commission  is  now 
running  on  credit.  It  is  not  a lack  of  knowledge  on  the  part  of  medical  men  of  Detroit  that  prevents  us 
handling  this  matter,  but  a lack  of  money.  I have  no  power  to  lock  a man  in  his  house;  t and,  until  we 
can  get  isolation  hospitals,  we  can  do  no  better  than  we  are  doing  at  present.  A system  of  police  quarantine 
is  impossible.^  If  the  State  Board  of  Health  can  put  $500,000  in  our  hands  we  might  follow  their  instruc- 
tions.:}: The  law  provides  for  isolation,  but  I have  no  power  to  lock  a person  up.  It  is  impossible  to 
quarantine  a tenement  house ; and,  if  I should,  the  inmates  would  all  come  down  with  the  disease.  We 
take  certain  precautions  in  issuing  permits  to  go  to  work.  I cannot  lock  a man  up  unless  I can  provide 
him  food.§  I shall  continue  to  issue  permits,  no  matter  if  contrary  to  law. 

Dr.  Hazlewood  asked  what  they  did  in  cases  of  varioloid. 

Dr.  Duffield— We  take  them  to  the  hospital  for  such  cases,  provided  for  by  the  city;  and,  upon  recovery 
or  death,  we  burn  all  infected  clothing,  and  the  city  pays  the  expense. 

Dr.  Hazlewood— Do  you  regard  small-pox  as  more  dangerous  than  scarlet  fever  or  diphtheria? 

Dr.  Duffield— No.  Small-pox  is  an  adult  disease. 

Dr.  Vaughan— Many  times  more  people  die  every  year  of  diphtheria  than  of  small-pox,  in  Michigan. 

Dr.  Lundy — Vaccination  and  other  measures  can  be  resorted  to,  to  suppress  small-pox. 

That  is  so,  said  Dr.  Vaughan,  and,  because  there  is  no  vaccination  for  diphtheria,  is  a good  reason  why 
diphtheria  should  be  quarantined. 

Dr.  Lundy  said  that  sometimes  four  or  five  Polish  families  resided  in  the  same  house,  and  to  talk  about 
isolating  a case  in  such  a house,  without  its  removal,  was  simply  futile.  It  would  cost  a great  deal  of 
money  to  isolate  these  cases,  but  we  cannot  get  this  money.  I am  in  sympathy  with  all  of  the  work  of 
the  State  Board  of  Health,  as  they  are  doing  a great  and  good  work;  but,  while  in  sympathy  with  the 
State  Board,  I wish  to  help  our  efficient  health  officer  to  explain  the  difficulties  under  which  the  Detroit 
Board  is  laboring. 

Dr.  Vaughan  said,  to  lock  five  or  six  well  children  in  a house  with  a child  who  has  diphtheria  or  small- 
pox is  not  isolation,  that  is  murder,  that  is  what  that  is.  Dr.  Vaughan  then  read  the  law,  where  it  pro- 
vides that  the  board  of  health  shall  provide  a hospital  for  small-pox  or  other  contagious  disease  patients. 
Dr.  Vaughan  said  that  there  were  more  people  to  the  acre  in  the  city  of  New  York  than  in  any  other  part 
of  this  continent;  yet  their  death-rate  would  not  compare  with  that  of  Detroit. 

Dr.  Lundy — The  city  of  Detroit  has  poor  sewers  in  some  localities,  and  cesspools  are  allowed  to  stand. 

Yes,  said  Dr.  Duffield,  and  these  cesspools  are  established  by  ordinance. 

Dr.  Carstens  asked  Dr.  Vaughan  if  he  knew  why  the  death-rate  was  so  much  lower  in  New  York  than  in 
Detroit,  and  Dr.  Vaughan  replied  that  it  was  because  they  had  a more  perfect  system  of  isolation  of  dan- 
gerous diseases. 

Exactly,  said  Dr.  Carstens,  they  have  the  laws,  and  have  the  money  to  enforce  them.  Give  us  the 
same,  and  we  will  take  care  of  the  diphtheria  and  scarlet  fever  in  Detroit.  New  York  does  not  boast  of 
how  little  its  health  department  costs  them,  as  does  the  city  of  Detroit.  They  know  what  the  spread  of 
these  diseases  means  in  their  dense  population,  and  they  act  like  sensible  people,  and  are  not  afraid  to 
spend  a few  dollars  in  the  restriction  of  disease.  All  we  need  in  Detroit  is  the  money,  and  we  wish  that 
the  State  Board  of  Health  would  help  us  to  get  it. 

Drs.  Lundy,  Carstens,  Duffield  and  Clark  all  said  that  money  was  what  they  wanted,  and  hoped  that  the 
State  Board  of  Health  would  help  them  get  it. 

In  reply  to  Dr.  Vaughan’s  question  of  “ What  does  the  Detroit  Board  consider  the  dangerous  commu- 
nicable diseases?”  Dr.  Duffield  said  that  scarlet  fever,  diphtheria,  typhus,  small-pox  and  glanders  were 
placarded,  and  placed  under  rules  arranged  by  the  Detroit  Board. 

Dr.  Vaughan  asked  Health  Officer  Duffield  what  was  done  when  a case  of  dangerous  disease  was 
reported,  for  instance  diphtheria. 

Dr.  Duffield.— The  patient  and  inmates  of  the  infected  house  are  given  instructions,  and  a pamphlet  of 
instructions  is  sent  to  the  infected  house. 

Dr.  Vaughan  asked  how  he  knew  that  his  instructions  were  carried  out.  Do  you  send  around  a police- 
man to  see  that  the  instructions  are  carried  out? 

Dr.  Duffield  said  that  they  depended  upon  the  attending  physician  to  see  that  the  instructions  were  car- 
ried out ; he  is  the  custodian  of  the  life  of  the  patient,  and  we  rely  upon  the  honor  of  the  physician  to  see 
that  this  is  done.  Dr.  Carstens  said  he  would  like  to  catch  Dr.  Duffield  sneaking  around  his  patients ; if 
he  caught  him  at  it,  he  thought  he  would  give  Dr.  Duffield  a good  talking  to. 

Dr.  Vaughan  said  that  the  State  law  provides  a penalty  to  whoever  disobeys  the  orders  of  the  health 
officer,  and  this  implies  that  some  officer  should  see  that  his  instructions  are  carried  out. 

Dr.  Duffield  said  that  he  sent  a policeman,  with  a placard  to  be  put  up,  but  relied  upon  the  physician 
to  see  that  the  instructions  of  the  board  are  carried  out. 

t [The  State  Board  of  Health’s  instructions  are  not  what  Dr.  Duffield  appears  to  think.  H.  B.  B.] 

§ [This  is  required  by  law.  Act  137,  laws  of  18S3.  H.  B.  B.,  Sec.  State  Board. J 


12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Dr.  Vaughan  asked  who  disinfected,  after  a person  dies  or  recovers,  in  a case  of  scarlet  fever  or  diph- 
theria, to  which  Dr.  Driffield  said  “ Our  Disinfector.” 

Dr.  Vaughan  asked  what  disinfectants  were  used.  Dr.  Duffield  replied— Those  recommended  by  the 
State  Board  of  Health,— sulphur  and  corrosive  sublimate. 

Dr.  Vaughan  asked  who  was  the  one  to  give  the  convalescing  patient  permission  to  go  out.  Dr.  Duf- 
field replied  that  the  attending  physician  gave  that  permission,  and  that  he  had  no  right  to  doubt  the 
physician ; and,  so  long  as  the  law  of  Michigan  allows  quacks  to  practice,  the  public  must  take  the 
consequences. 

Dr.  Jennings  said  that  he  did  not  agree  with  Drs.  Carstens  and  Duffield,  and  that  he  would  have  no 
■objections  to  the  health  officer  coming  around  and  looking  after  the  sanitary  affairs,  as  they  were  not 
expected  to  look  after  the  treatment,  and  that  he  always  referred  any  question  of  sanitation  to  the  Board 
of  Health.  It  is  almost  impossible  for  the  profession  in  attending  a case  of  contagious  disease,  to  look 
after  all  the  sanitary  conditions,  and  do  it  perfectly. 

Dr.  Carstens  said  that  when  he  was  president  of  the  Board  of  Health,  some  years  ago,  the  law  was  that 
attending  physicians  could  report  the  patient  well,  and  that  many,  suffering  from  scarlet  fever,  were 
■reported  well  within  a week.  We  worked  until  we  got  the  law  changed  so  that  no  case  of  scarlet  fever 
or  diphtheria  could  be  reported  well  under  four  weeks;  but  so  long  as  druggists  are  allowed  to  prescribe 
for  sore  throats,  we  will  have  exposures  to  diphtheria.  You  cannot  separate  children,  and  the  only  way 
is  to  have  a hospital  where  a child  suffering  from  a sore  throat  can  be  isolated. 

Dr.  Avery  said  that  he  thought  that  the  health  officer  and  physicians  misunderstood  the  object  of  the 
visit  of  the  committee  to  Detroit;  that  they  did  not  come  there  to  criticise,  but  to  see  if  they  could  be  of 
any  help  in  the  restriction  and  prevention  of  disease.  We  are  not  law  makers,  cannot  make  the  quacks 
get  out  of  the  State;  what  we  wish  is  to  get  the  necessary  information  60  that  we  can  aid  you.  The 
State  Board  of  Health  has  found  that  public  sentiment  is  the  greatest  help  in  their  work.  In 
“the  case  of  an  outbreak  of  small-pox  there  is  plenty  of  public  sentiment,  and  if  the  health  officer  did 
not  attend  to  his  duties,  the  locality  would  force  him  to  do  so.  But  what  we  want  is  the  proper 
public  sentiment  in  the  case  of  diphtheria  and  scarlet  fever,  and  we  wish  to  have  this  in  Detroit. 
We  have  no  trouble  in  the  country  in  restricting  and  preventing  the  spread  of  the  different  diseases. 
(He  cited  instances  in  his  resident  city,  Greenville,  and  showed  how  complete  isolation  and  disinfec- 
tion restricted  dangerous  diseases.)  We  can  restrict  dangerous  diseases  in  the  country,  and  I see  no  rea- 
son why  you  cannot  do  it  in  Detroit.  The  State  Board  of  Health  wishes  to  aid  you  in  getting  what 
you  wish  and  need,  and  we  care  to  have  no  friction  between  the  boards. 

Dr.  Lundy  said  that  he  thought  that  the  citizens  of  Michigan  knew  that  the  State  Board  of  Health 
was  doing  a good  work,  and  appreciated  the  great  work  they  were  doing.  “ I know  that  they  have  saved 
human  lives,  and  have  saved  millions  of  dollars  to  the  commonwealth  of  this  State.” 

Dr.  Hitchcock  spoke  of  the  law  and  rules  relative  to  the  removal  of  the  placard  from  an  infected 
house,  and  said  that  he  had  the  greatest  respect  for  the  work  of  the  State  Board  of  Health.  He  also 
spoke  of  a case  of  diphtheria  which  he  attended,  and  how  he  gave  full  instructions  and  orders  that  the 
extra  bed  in  the  room  on  which  the  father  slept  should  be  moved  out,  and  when  he  came  again  he  found 
nothing  had  been  done ; he  was  then  very  emphatic  and  they  obeyed.  He  thought  that  an  intelligent 
sanitary  police  officer  would  do  a great  deal  of  good,  if  he  could  happen  around  at  the  right  time.  Peo- 
ple generally  are  afraid  of  a man  with  brass  buttons,  and  would  do  for  him  what  they  would  not  do  for  a 
physician 

Dr.  Lundy  asked  if  it  would  not  be  productive  of  great  good  to  have  three  or  four  of  the  sanitary  offi- 
cers to  happen  around  at  the  right  time.  Just  a few  ought  to  be  obtained  in  some  way. 

Dr.  Duffield  thought  that  the  contagious  disease  hospitals  would  be  the  easiest  way  to  get  over  the 
difficulty,  and  that  it  would  be  the  cheapest  way  in  the  end. 

Dr.  Avery  said  he  knew  that  the  State  Board  of  Health  would  be  pleased  to  assist  the  Detroit  board  of 
health  to  get  anything  they  needed. 

Mayor  Pingree  said  that  he  wished  to  thank  the  State  Board  for  coming;  and  that  he  knew  if  this 
meeting  had  happened  before  the  meeting  of  the  board  of  estimates  that  the  appropriation  would  have 
been  forthcoming.  He  spoke  of  a man  coming  into  the  Detroit  club  rooms  who  had  just  lost  a child 
from  diphtheria,  and  said  that  this  man’s  friends  were  crowding  around  him  and  condoling  with  him, 
but  he  was  very  careful  to  keep  as  far  away  from  him  as  possible,  as  he  knew  that  there  was  danger  of 
carrying  the  contagion. 

Dr.  Vaughan  again  read  the  law  relative  to  when  the  small-pox  or  other  disease  dangerous  to  the  pub- 
lic health  shall  break  out  the  “ board  of  health  shall  immediately  provide  a hospital  ” and  asked  Dr. 
Duffield  if  he  did  not  think  the  law  ample.  Dr.  Duffield  replied  that  he  did.  Dr.  Vaughan  asked  what 
steps  would  have  to  be  taken  to  get  these  hospitals. 

Dr.  Duffield  replied  that  the  poor  fund  was  only  $6,000,  and  the  poor  commissioner  thought  that  a 
plea  for  hospitals  to  the  board  of  estimates  would  get  them,  but  we  made  the  plea  and  you  can  see  the 
outcome.  We  are  expecting  to  have  to  remove  our  present  hospital  for  small-pox  out  further,  as  they 
keep  extending  the  city  limits,  and  I have  a proposition  before  the  board  for  a series  of  cottage  hospitals 
when  this  old  hospital  is  abandoned,  and  that  they  be  called  isolation  hospitals  instead  of  pest-houses  or 
contagious  disease  hospitals. 

Dr.  Hazlewood  said  that  he  could  sympathize  with  a health  officer  in  a large  city,  where  everyone  is  so 
crowded,  and  that  the  only  way  was  to  have  an  isolation  hospital,  and  that  he  would  be  in  favor  of  a 
series  of  hospitals  instead  of  one  large  building. 


ABSTRACT  OF  PROCEEDINGS,  JULY  12,  1892. 


13 


Dr.  Vaughan  asked  if  a few  sanitary  police,  if  they  were  men  above  the  average  brightness,  would  not 
do  a great  deal  of  good  in  restricting  the  liberty  of  the  patients  and  in  the  education  of  the  people  in 
sanitary  matters. 

Dr.  Vaughan  recommended  that  a committee  consisting  of  Mayor  Pingree,  Dr.  Henry  B.  Baker,  and 
Health  Officer  Duffield,  be  appointed  by  this  meeting  to  draw  up  a statement,  to  the  common  council,  of 
the  necessity  of  cantagious-disease  hospitals. 

Dr.  Clark  thought  it  would  be  well  to  have  included  in  that  recommendation  the  largest  medical 
society  in  the  city  so  as  to  have  as  many  physicians  as  possible  interested  in  the  matter. 

Dr.  Vaughan  thought  that  it  would  be  better  to  have  the  sanction  of  this  meeting  and  bring  in  the 
medical  societies  later. 

Dr.  Jennings  suggested  that  the  recommendation  be  for  a larger  appropriation  to  the  Board’s  present 
appropriation  so  that  it  could  get  its  own  police. 

Dr.  Avery  asked  Dr.  Duffield  if  he  thought  there  would  be  more  than  100  placards  out  in  one  day,  today 
for  instance.  * 

Dr.  Duffield  said  that  he  thought  there  might  be  from  150  to  190  out  that  day,  and  that  they  were  very 
much  scattered. 

Dr.  Lundy  asked  Dr.  Duffield  if  he  thought  that  ten  police  would  be  sufficient  if  they  were  mounted. 

Dr.  Duffield  replied  that  he  did,  and  that  most  of  the  cases  were  outside  of  a radius  of  two  and  one-half 
miles  from  the  City  Hall.  He  asked  what  they  were  going  to  do  with  people  they  found  violating  the 
health  laws,  and  arrested  when  they  were  sick,  some  of  the  judges  do  not  wish  to  have  contagious  diseases 
brought  into  their  presence. 

Dr.  Lundy  asked  Mayor  Pingree  if  he  did  not  think  that  they  could  get  the  money. 

Mayor  Pingree  said  he  did  not  know  that  things  were  so  bad  in  Detroit,  and  he  was  sure  that  most 
people  in  Detroit  were  as  ignorant  as  himself;  but  if  the  people  were  educated  on  this  subject,  there  would 
be  no  trouble  in  getting  the  necessary  amount. 

Dr.  Lundy  asked  if  there  was  not  some  way  to  get  it  before  the  next  meeting  of  the  Board  of  Estimates, 
and  Dr.  Duffield  replied  that  an  appeal  to  the  common  council  might  do  it. 

Dr.  Lundy  thought  by  a combined  action  of  the  two  boards,  and  with  the  cooperation  of  the  physicians 
in  Detroit  there  would  be  little  doubt  but  that  they  would  get  the  money. 

Dr.  Lyster  thought  that  this  combined  action  would  be  a good  step  to  take,  and  that  the  chances  were 
good  for  getting  the  money.  He  also  spoke  of  the  scarlet  fever  which  had  occurred  on  Jefferson  avenue, 
as  occurring  on  the  bright  side  of  the  avenue,  and  thought  that  it  might  be  caused  by  the  patients  recover- 
ing from  the  disease  walking  on  that  side  of  the  street  more  than  on  the  other  side. 

Dr.  Jennings  said  that  he  had  noticed  the  same  thing,  but  upon  investigation  found  that  the  children 
having  the  disease  were  mostly  attending  one  school,  and  thought  that  was  the  explanation. 

The  following  resolutions  were  presented  by  Dr.  Vaughan: 

Resolved , That  the  Health  Department  should  send  officials  frequently  to  infected  houses  to  see  that 
patients  are  isolated,  and  that  other  rules  of  the  board  of  health  are  complied  with. 

Resolved , That  we  recommend  a committee  consisting  of  Mayor  Pingree,  Secretary  Baker  of  the  State 
Board  of  Health,  and  Health  Officer  Duffield  to  draw  up  a statement  of  the  great  need  of  contagious  dis- 
ease hospitals. 

Dr.  Clark  objected  to  the  last  clause  of  the  first  resolution,  where  it  reads  “ that  other  rules  of  the  board 
of  health  be  complied  with.”  He  said  that  the  resolution  looked  very  simple  and  harmless,  but  if  it 
passed  it  would  antagonize  most  of  the  physicians  in  Detroit.  I should  not  like  to  have  a policeman 
come  in  and  tell  me  that  the  patient  should  be  moved  on  account  of  poor  ventilation  or  recommend  some 
other  kind  of  treatment. 

Dr.  Lundy  said  it  was  a mistaken  idea  that  the  sanitary  precautions  should  interfere  with  the  treatment. 

Dr.  Clark  thought  that  there  would  be  a clashing  between  the  physician  and  the  board  of  health  when 
the  board  of  health  dictated  as  to  what  should  be  done  in  the  case  of  disinfection,  etc.,  but  Dr.  Lundy 
thought  there  would  be  no  such  clashing. 

Relative  to  the  spreading  of  dangerous  diseases  in  the  schools,  Dr.  Vaughan  asked  Health  Officer  Duf- 
field what  was  done  to  let  the  teacher  know  that  such  a child  was  infected  with  a dangerous  disease.  Dr. 
Duffield  replied  that  the  superintendent  was  notified  every  morning  of  new  cases,  and  he  had  postals  6ent 
to  the  principals  of  the  several  schools. 

In  connection  with  this  subject,  Mrs.  Lemkie  of  546  Fifteenth  Street,  said  she  had  reason  to  believe  that 
the  principals  of  the  schools  were  not  always  notified  from  the  superintendent’s  office.  She  cited  a case 
where  a card  was  put  up  on  a house  near  her  residence  and  she  immediately  went  to  the  principal  of  the 
Bagley  school  to  see  if  the  children  of  that  infected  house  were  in  attendance  at  school  and  found  that 
they  were,  and  that  the  principal  had  heard  nothing  of  the  existence  of  this  diphtheria;  she  also  found  her 
own  little  boy  had  been  looking  down  the  throats  of  the  children  complaining  of  sore  throat  who  were 
from  the  infected  house. 

Dr.  Duffield  said  the  fault  was  with  the  superintendent  then,  for  his  office  is  notified  every  morning 
between  nine  and  ten  o’clock. 

Mrs.  Lemkie  said  the  difficulty  was,  they  had  a politician  instead  of  a superintendent  of  schools. 

Dr.  Lenox  corroborated  what  Mrs.  Lemkie  had  stated,  and  in  his  own  practice  he  could  cite  several 
instances  where  the  board  of  education  had  been  notified  but  no  notice  had  been  sent  to  the  teacher.  He' 
also  stated  that  he  knew  that  convalescing  children  were  too  frequently  permitted  to  go  to  school,  andi 
were  the  means  of  spreading  the  dangerous  diseases  in  many  instances. 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Dr.  Duffield  said  that  there  ought  to  be  but  little  danger  from  spreading  the  diseases  in  that  way,  for 
the  patient  is  held  in  quarantine  twenty-eight  days,  and  there  is  a time  for  disinfection,  and  the  school 
authorities  generally  require  that  the  child  be  kept  isolated  for  ten  days  more. 

Dr.  Gray  (member  State  Board  of  Health) , said  that  the  lack  of  restriction  of  a child’s  liberty  upon 
apparent  recovery,  was  too  frequently  the  source  of  spreading  a disease,  and  it  was  at  that  time  that  a 
sanitary  inspector  would  do  the  greatest  good,  to  see  that  convalescents  were  isolated  from  the  public. 
Several  sanitary  inspectors  to  drop  down  on  an  infected  locality  at  the  right  time,  would  aid  Health  Offi- 
cer Duffield  very  much  in  his  public-health  work. 

Dr.  Duffield  said  that  there  were  no  sanitary  policemen  on  his  pay-roll,  but  that  he  had  the  privilege  to 
use  some  of  the  police  from  the  city  department  for  the  purpose  of  placing  placards,  etc.,  but  would  be 
very  glad  indeed,  to  have  a number  for  his  special  use. 

Dr.  Lenox  thought  that  sanitary  police  would  be  the  means  of  making  many  physicians  angry,  for  he 
had  already  complaints  that  the  police  were  often  impertinent  and  insolent  in  the  discharge  of  their 
duties.  He  thought  that  the  attending  physician  was  the  best  detective  to  see  that  the  rules  and  instruc- 
tions of  the  Board  of  Health  were  complied  with. 

Dr.  Clark  made  a motion  to  strike  out  that  part  of  the  first  resolution  where  it  read  “ that  other  rules 
of  the  Board  of  Health  be  complied  with.”  The  motion  was  lost. 

A vote  was  taken  on  the  adoption  of  the  resolutions  as  read,  but  the  chairman  was  unable  to  decide, 
and  called  for  a rising  vote  which  adopted  the  resolutions. 

On  motion  the  committee  adjourned  at  5:00  P.  M. 

D.  W.  H.  Moreland  sent  a communication  of  which  the  following  is  an 
abstract: — 

“ As  you  will  see  by  my  card,  enclosed,  I live  in  Detroit,  and  in  soliciting  freight  and  passenger  business 
there  I get  around  the  city  considerably,  and  am  forced  to  notice  the  extremely  filthy  condition  of  the 
alleys  and  back  yards,  where  there  are  accumulated  hundreds  of  tons  of  garbage,  in  a putrefying  condition, 
which  have  accumulated  since  the  shutting  down  of  the  garbage  works  nearly  a year  ago.  The  proper 
authorities  of  the  city  of  Detroit,  with  shame  to  themselves,  should  be  forced  to  do  something  for  the 
proper  collection  and  disposal  of  the  city’s  garbage.  * * * * There  is  such  an  immense  volume  of 
travel  constantly  in  and  out  of  Detroit  from  the  State  at  large,  that  you  certainly  do  right  to  insist  on  an 
explanation  from  the  city  authorities,  and  a prompt  and  effective  remedy.  The  Board  of  Health  in 
Detroit  are  practically  powerless  in  the  matter,  but  the  mayor,  aldermen  and  Board  of  Public  Works  are 
to  blame,  particularly  the  mayor  and  aldermen.  The  amount  of  infectious  diseases,  particularly  diph- 
theria and  scarlet  fever,  which  the  city  has  been  inflicted  with  the  last  few  months,  is  a disgrace  to  the 
city  and  the  State  at  large,  and  to  any  civilized  country  on  God’s  green  earth.” 

Replies  to  questions  in  the  schedules,  used  by  the  committee,  have  been 
received  by  mail  from  a number  of  physicians  and  other  citizens  of  Detroit. 

Dr.  David  Inglis  says,  relative  to  work  to  obtain  cooperation  of  citizens, 
UI  think  the  sanitary  conventions  [under  the  auspices  of  the  State  Board 
of  Health]  have  been  of  incalculable  benefit,  and  I do  not  see  why  a series 
of  local  or  ward  sanitary  meetings  in  Detroit  could  not  be  carried  out.” 
* * * * “In  the  supervision  of  plumbing  and  drainage  in  new  buildings  we 
are  far  behind  New  York,  Washington,  or  Buffalo;  every  plumber  does  as 
he  sees  fit;  drainage  is  done  in  a reckless  way.  We  will  never  get  rid  of 
diphtheria  by  placards,  disinfectants,  quarantine  or  any  expedients  as  long 
as  our  clay  soil  is  saturated  from  loosely-jointed  crock  drains  running 
under  cellar  floors.” 

Dr.  W.  B.  Sprague  replied  to  many  of  the  questions  in  the  schedules, 
and  from  his  replies  one  would  infer  that  everything  possible  to  be  done 
was  being  done  in  Detroit  to  restrict  dangerous  diseases.  There  being 
doubt  as  to  whether  Dr.  Sprague  understood  the  questions  to  apply  to  the 
city  as  a whole,  he  was  asked  to  explain,  and  he  says  his  replies  related  to 
his  own  practice  only. 

Dr.  Charles  W.  Hitchcock  replied  to  a number  of  the  questions.  He, 
also,  seems  to  have  replied  mainly  concerning  his  own  practice. 

There  is  no  question  that,  in  the  practice  of  the  most  intelligent  and 
philanthropic  physicians,  the  proper  measures  for  the  restriction  of  the 
dangerous  diseases  are  ordered,  and,  so  far  as  the  physician  alone  can  do 
so,  they  are  enforced;  but  not  all  families,  in  time  of  great  trial,  will 
conform  to  restrictive  measures,  not  for  their  own  good  but  for  the  benefit 
of  the  public;  and  the  physician’s  duty  is  primarily  to  the  family  that 


ABSTRACT  OF  PROCEEDINGS,  JULY  12,  1892. 


15 


employs  him ; the  public  interests  are  to  be  watched  and  guarded  by  the 
physicians  (health  officer,  and  board  of  health ) and  other  officials  employed 
and  paid  by  the  public,  for  that  especial  service. 

The  set  of  schedules  which  the  committee  left  with  the  health  officer,  to 
be  filled  out  by  him,  have  not  been  received  from  him.  No  response  has 
been  received  from  any  medical  member  of  the  Detroit  board  of  health. 

James  E.  Pittman,  Superintendent  of  Police,  replied  to  two  questions, 
relative  to  what  is  done  with  reference  to  dangerous  communicable  dis- 
eases, that  “The  members  of  the  Detroit  police  force  have  acted  under 
instructions  from  the  health  officer.”  Replying  to  what  is  done — “What- 
ever is  directed  by  the  health  officer.” 

The  only  response  by  any  member  of  the  Detroit  board  of  health  to  the 
requests  for  replies  to  the  schedules,  stating  the  specific  facts  as  to  just 
what  are  the  methods  generally  employed  in  Detroit,  is  as  follows: — 

Hon.  Frank  J.  Hecker,  President  Metropolitan  Police,  and  member  of 
the  Detroit  Board  of  Health,  referring  to  the  schedules  and  requests  for 
facts,  replied  “I  beg  to  advise  you  that  I have  referred  the  same  to  Dr. 
Samuel  P.  Duffield,  health  officer  of  this  city,  as  I have  no  personal  know- 
ledge of  the  subject  matter  thereof.” 

In  the  absence,  from  this  meeting  of  the  State  Board,  of  the  chairman 
of  the  committee,  this  subject  was  not  finally  disposed  of,  but  the 
following  is  a — 

Summary  of  the  Most  Important  Fficts  Learned  Concerning  the  Difficulties  in 
Bestriding  Dangerous  Diseases  in  Detroit.  What  is  done  in  Detroit,  Com- 
pared with  what  the  State  Board  of  Health  has  Generally  Recommended. 

According  to  the  evidence  collected,  Dr.  Duffield  does  not  appear  to 
understand  the  views  of  the  Secretary  of  the  State  Board  of  Health,  nor 
the  system  of  work  recommended  by  the  State  Board.  The  Secretary  of  the 
Board  does  not  advise  that  the  local  health  officer,  as  Dr.  Duffield  expresses 
it,  “lock  up  the  whole  family,”  in  any  case.  There  is  no  State  law  directly 
authorizing  that.  The  Secretary  recommends  that  the  health  officer  com- 
ply with  the  State  laws,  especially  with  Act  137,  laws  of  1883,  which  (unless 
he  is  directed  by  his  local  board  to  do  otherwise),  requires  the  health  officer — 

"To  order  the  prompt  and  thorough  isolation  of  those  sick  or  infected  with  such  disease,  so  long  as 
there  is  danger  of  their  communicating  the  disease  to  other  persons ; to  order  the  prompt  vaccination  or 
isolation  of  persons  who  have  been  exposed  to  small-pox;  to  see  that  no  person  suffers  for  lack  of 
nurses  or  other  necessaries  because  of  isolation  for  the  public  good;  to  give  public  notice  of  infected 
places  by  placard  on  the  premises,  and  otherwise  if  necessary;  to  promptly  notify  teachers  or  superin- 
tendents of  schools  concerning  families  in  which  are  contagious  diseases;  to  supervise  funerals  of 
persons  dead  from  scarlet  fever,  diphtheria,  small-pox,  or  other  communicable  disease  which  endangers 
the  public  health;  to  disinfect  rooms,  clothing,  and  premises,  and  all  articles  likely  to  be  infected,  before 
allowing  their  use  by  persons  other  than  those  in  isolation;  to  keep  the  president  of  his  own  board  of 
health,  and  the  Secretary  of  the  State  Board  of  Health  constantly  informed  respecting  every  outbreak 
of  a disease  dangerous  to  the  public  health,  and  of  the  facts  so  far  as  the  same  shall  come  to  his  know- 
ledge, respecting  sources  of  danger  of  any  such  diseased  person  or  infected  article  being  brought  into  or 
taken  out  of  the  township,  city,  or  village  of  which  he  is  the  health  officer.” 

If  the  health  officer  gives  these  orders,  as  the  law  requires,  then  any 
person  who  disobeys  one  of  these  orders  is  liable  to  a fine,  and  to  imprison- 
ment if  the  fine  is  not  paid.  If  each  case  is,  as  it  should  be,  kept  under 
surveillance  by  the  health  officer,  through  his  agents,  who  may  be  sanitary 
policemen  or  sanitary  inspectors,  any  violation  of  the  orders  may  be 
learned  and  the  legal  penalties  inflicted.  If,  in  Detroit,  this  were  generally 
done,  it  would  soon  be  generally  known,  and  the  laws  and  orders  would 
generally  be  obeyed.  It  seems  that  in  Detroit  this  law  is  not  fully  complied 
with  by  the  health  officer,  that  the  isolation  of  infected  households  is  not 
ordered,  but  only  advised,  that  no  sanitary  inspector  finds  out  whether  or 


16 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


not  the  order  or  advice  is  complied  with,  and,  therefore,  that  no  thorough, 
systematic  attempt  is  made  to  isolate  inmates  of  houses  infected  with  diph- 
theria and  scarlet  fever;  permits  are  given  for  adults  to  go  out  from  infected 
premises  to  work.  So  long  as  the  most  important  law  for  the  restriction  of 
disease  is  disregarded  by  the  chief  officer  of  health  in  the  city,  or  negatived 
by  the  action  of  the  local  board  of  health,  there  is  little  hope  for  progress 
in  the  restriction  of  the  dangerous  communicable  diseases.  It  is  not  to  be 
wondered  at,  it  follows  as  a matter  of  course,  that  diphtheria  and  scarlet 
fever  are  very  prevalent  in  Detroit. 

The  committee  seem  to  have  found  that  perhaps  the  most  important  “ dif- 
ficulty under  which  the  Detroit  officers  are  laboring  for  the  restriction  of  the 
dangerous  diseases”  is  the  lack  of  cooperation  with  the  health  officials  by  the-  i 
other  city  officers,  and  by  the  people  generally.  This  was  testified  to  by  his 
honor  the  Mayor,  by  Dr.  Duffield,  and  by  others ; it  was  spoken  of  by  president 
Avery  of  the  State  Board  of  Health;  Mayor  Pingree  expressed  the  view  that 
if  the  citizens  of  Detroit  and  their  official  representatives  knew  the  facts  they 
would  readily  respond  to  the  proper  requests  of  the  health  department.  This 
is  in  accordance  with  the  experience  of  the  State  Board  of  Health,  and  with 
the  theory  of  its  system  of  work,  which  is  not  accepted  and  acted  upon  by 
the  Detroit  health  department.  The  theory  of  the  State  Board  is  that  an 
“ educational  campaign  ” should  be  continually  carried  on  for  the  purpose 
of  building  up  a correct  public  opinion  on  the  restriction  of  the  most 
dangerous  diseases.  The  State  Board  issues  pamphlets  on  the  best  meas- 
ures for  the  restriction  of  each  of  the  most  dangerous  diseases,  and  it 
wants  these  pamphlets  distributed,  by  the  local  health  department,  to  the 
neighbors  of  every  house  in  which  there  is  a dangerous  communicable 
disease.  In  time,  if  this  is  done,  all  the  people  are  thus  reached,  at  a time 
of  special  danger  from  disease,  when  the  pamphlet  is  read,  because  of 
unusual  interest,  and  heeded  because  issued  by  State  authority,  and  the 
result  is  a public  sentiment  that  will  sustain  and  support  proper  health 
measures,  carried  on  by  the  local  health  department. 

In  Detroit,  a pamphlet,  issued  by  the  local  board,  is  left  with  the  inmates 
of  the  infected  premises;  but  there  the  “ educational  campaign  ” stops,  the 
people  are  left  uninstructed,  and  the  health  officials  continue  to  be  power- 
less, for  lack  of  cooperation,  not  only  of  the  people  generally,  but  also  of 
those  other  city  officials  who  control  the  appropriation  and  expenditure 
of  money;  isolation  hospitals  are  not  provided  for,  because  few  of  the 
people  have  been  instructed  concerning  the  necessity  or  importance  of 
isolation  for  the  restriction  of  the  most  common  diseases;  disinfecting 
stations  are  not  provided,  because  few  of  the  people  know  how  important 
disinfection  is,  for  the  restriction  of  diphtheria  and  scarlet  fever. 

The  State  Board  of  Health  issues  a diagram  which  shows  at  a glance, 
and  conclusively,  because  representing  indisputable  statistics,  the  two 
important  facts — that  isolation  and  disinfection  do  restrict  diphtheria.  It 
issues  a diagram  that  shows  these  same  two  important  facts  concerning  scar- 
let fever.  One  of  these  diagrams,  with  a copy  of  the  State  Board’s  pamphlet 
on  the  restriction  of  the  disease  then  threatening,  should  be  placed  before 
every  neighbor  of  a house  in  which  there  occurs  a case  of  one  of  these  dis- 
eases. If  this  were  done  in  Detroit,  it  would  not  be  long  before  there  would 
be  an  enlightened  public  opinion  which  would  tend  to  support  the  local 
health  officials  in  proper  efforts  for  the  restriction  of  those  two  dangerous 
communicable  diseases  which  are  now  so  prevalent  in  Detroit. 

Henry  B.  Baker, 

Secretary. 


(s»  I L~l  " C’T 

'(Yl  S U 

t wy 


ABSTRACT  OF  PROCEEDINGS 

OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


SPECIAL  MEETING,  SEPT.  29  AND  30,  1893. 


[199.] 

A special  meeting  of  the  Michigan  State  Board  of  Health  was  held  at 
Lansing,  Sept.  29  and  30,  1893.  The  members  present  were:  Hon.  Frank 
Wells,  President,  Lansing;  Prof.  Delos  Fall,  M.  S.,  Albion;  George  H. 
Granger,  M.  D.,  Bay  City;  Samuel  G.  Milner,  M.  D.,  Grand  Bapids;  and 
Henry  B.  Baker,  Secretary,  Lansing. 

The  regular  business  of  auditing  of  bills  and  accounts  was  transacted. 

TUBERCULAR  DISEASES  DECLARED  “ DISEASES  DANGEROUS  TO  THE  PUBLIC 

HEALTH.” 

A resolution  offered  by  Dr.  Henry  B.  Baker  was  unanimously  adopted, 
placing  consumption  (and  other  diseases  due  to  the  tubercle  bacillus)  on 
the  list  of  diseases  dangerous  to  the  public  health,  which  are  required  by 
law  to  be  reported  by  physicians  and  householders.  This  means  that 
henceforth  still  greater  effort  than  in  the  past  is  to  be  put  forth  to  restrict 
the  ravages  of  this  “ great  white  plague,”  which  causes  more  deaths  in 
Michigan  than  any  other  disease.  This  important  move  by  the  Board 
calls  for  the  most  earnest  cooperation  of  health  officers,  physicians,  and 
the  people  generally.  The  resolution  is  as  follows: 

“ Resolved , That  hereafter,  consumption  (and  other  diseases  due  to  the 
Bacillus  tuberculosis)  shall  be  included  in  the  official  list  of  ‘Diseases 
dangerous  to  the  public  health’  referred  to  in  sections  1675  and  1676, 
Howell’s  statutes,  requiring  notice  by  householders  and  physicians  to  the 
local  health  officer,  as  soon  as  such  a disease  is  recognized.” 

[In  this  resolution  the  question  of  isolation  of  the  patient  is  not  mentioned.  Its  purpose  is  to  secure 
to  the  local  health  authorities  and  to  the  State  Board  of  Health  information  of  the  location  of  each  case 
of  this  most  dangerous  disease,  with  the  view  of  placing  in  the  hands  of  the  patient  reliable  information 
how  to  avoid  giving  the  disease  to  others,  and  in  the  hands  of  those  most  endangered,  information  how  to 
avoid  contracting  this  disease.] 


-ft , \ 0-4A 

"ft 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


HOW  OTHER  DANGEROUS  DISEASES  ARE  RESTRICTED. 

The  reporting  of  other  dangerous  diseases  to  the  State  Board  has 
enabled  it  to  place  pamphlets  and  leaflets  of  instructions  just  where  they 
would  do'  most  good,  and  at  a time  when  most  likely  to  be  read,  namely 
when  the  disease  is  actually  present  and  threatening.  Many  years  of 
experience  show  that  restrictive  measures  recommended  by  the  State 
Board  of  Health,  relative  to  dangerous  diseases,  have  been  the  direct 
means  of  great  reductions  in  the  death-rates  of  dangerous  diseases;  from 
scarlet  fever,  for  instance,  the  death-rate  is  only  about  half  what  it  was 
before  the  State  Board  of  Health  undertook  restrictive  measures.  When 
consumption  is  reported  it  can  be  dealt  with  in  a similar  manner, 
so  far  as  relates  to  the  teaching  of  the  people  how  to  restrict  it,  and  many 
cases  of  consumption  can  be  avoided  every  year.  It  is  a disease  easily 
restricted,  and  the  State  Board  of  Health  distributes  a pamphlet  telling 
just  how  to  do  it.  If  the  physicians  and  citizens  of  Michigan  will  report 
consumption  as  they  have  in  the  past  reported  other  dangerous  diseases, 
and  cooperate  with  the  local  health  officials  and  with  the  State  Board  of 
Health  in  its  efforts  to  instruct  the  people,  much  suffering  and  loss  of  life  ' 
can  be  prevented. 

PRINTING  AND  DISTRIBUTION  OF  PAMPHLETS  OF  INSTRUCTION. 

In  connection  with  the  subject  of  reprinting  the  leaflet  on  the  restriction 
of  dangerous  contagious  diseases,  in  several  different  languages  for  dis- 
tribution to  the  neighbors  of  the  persons  sick  with  a dangerous  disease, 
Drs.  Granger  and  Milner,  the  recently  appointed  members  of  the  Board, 
said  they  had  for  years  watched  with  interest  the  good  work  that  these 
instructive  pamphlets  had  been  doing  in  the  restriction  and  prevention  of 
the  several  diseases. 

The  Board  directed  the  Secretary  to  reprint  this  leaflet  in  several  dif- 
ferent languages.  Dr.  Granger  said  that  many  of  our  recently-arrived  for- 
eigners did  not  believe  that  some  of  these  diseases  were  dangerous,  and 
that  this  leaflet  was  just  what  was  wanted  to  educate  this  class  of  people, 
because  diphtheria  and  other  diseases  were  spread  among  them  and  by 
them  to  other  classes  of  people. 

In  foreign  countries  from  which  immigrants  are  coming  to  Michigan,  the 
dangerous  communicable  diseases  generally  are  more  prevalent  than  in 
Michigan,  where  restrictive  measures  have  been  in  force  for  many  years. 
Thus  the  death-rate  from  measles  is  much  greater  in  England  than  in 
Michigan.  In  many  of  the  foreign  countries  small-pox  is  common,  while 
there  is  none  now  in  Michigan. 

AMENDMENT  OF  RULES  FOR  IMMIGRANT  INSPECTION. 

The  Board  amended  its  rules  for  the  inspection  of  immigrants  at  the 
Michigan  border  by  adding  to  Rule  1 “and  no  immigrant  shall  come  into 
this  State,  or  travel  within  the  State,  until  inspected  under  these  rules,  and 
until  authorized  to  do  so  by  an  inspector  appointed  or  accredited  by  the 
Michigan  State  Board  of  Health.” 

Rule  5 was  so  amended  as  to  hold  immigrants  until  their  baggage  has 
been  disinfected. 

An  additional  rule  was  adopted  as  follows: 


ABSTRACT  OF  PROCEEDINGS,  SEPTEMBER  29-30,  1893. 


3 


Rule  7.  Dangerous  communicable  diseases  being  now  present  in  every 
country  from  which  immigrants  are  coming  into  Michigan,  no  immigrant, 
and  no  traveler  or  other  person  believed  by  the  State  Board  of  Health  or 
by  its  authorized  inspector  to  have  .been  exposed  to  and  liable  •to  convey 
cholera,  diphtheria,  or  other  dangerous  communicable  disease,  shall  pass 
through  Michigan,  or  from  one  township,  city  or  village  to  another  within 
the  State,  without  permission  from  the  State  Board  of  Health  or  its  author- 
ized inspector. 

The  following  resolution,  offered  by  Dr.  G ranger,  was  unanimously 
adopted: 

Resolved , That  it  is  the  will  of  this  Board  that  the  President  and  Secre- 
tary continue  to  take  such  action  as  may  be  necessary  to  enforce  the  rules 
of  this  Board  and  to  enforce  quarantine  at  the  Michigan  border  and 
within  the  State  against  diseases  dangerous  to  the  public  health,  and  to 
compel  any  railroad  company  operating  within  the  State  to  obey  the  State 
laws  and  the  rules  and  regulations  of  the  State  Board  of  Health  made 
under  the  law. 

MINNEAPOLIS,  ST.  PAUL  AND  SOO  R.  R.  VS.  STATE  BOARD  OF  HEALTH. 

About  July  6 an  order  was  served  on  each  member  of  this  State  Board 
of  Health  to  appear  at  Marquette,  July  15,  to  show  cause  why  a prelimi- 
nary injunction  should  not  issue  to  stop  the  inspection  of  immigrants  and 
travelers  under  the  rules  of  the  Michigan  State  Board  of  Health.  Accord- 
ingly the  Attorney  General  of  Michigan,  and  the  President  and  Secretary 
of  the  State  Board  of  Health,  went  to  Marquette,  to  appear  before  Judge 
H.  F.  Severens,  United  States  Circuit  Judge  of  the  Northern  Division  of 
the  Western  District  of  Michigan.  On  account  of  the  importance  of  the 
case  Judge  Severens  had  asked  U.  S.  Circuit  Judge  George  R.  Sage,  of 
Cincinnati,  to  sit  with  him. 

In  a few  days  the  finding  of  the  U.  S.  Judges  was  handed  down,  and  a 
copy  was  sent  to  the  office  of  the  Secretary  of  the  State  Board  of  Health, 
and  is  as  follows: 

CIRCUIT  COURT  OF  THE  UNITED  STATES,  WESTERN  DISTRICT  OF 
MICHIGAN— NORTHERN  DIVISION. 

Minneapolis,  St.  Paul  & S.  Ste.  Marie  Railway  Company, 

vs. 

Samuel  G.  Milner,  et  al.,  Members  of  and  constituting  the  State  Board  of 

Health  of  Michigan. 

On  motion  for  a preliminary  injunction.  Before  Judges  Severens  and 

Sage. 

The  bill  sets  forth  that  the  complainant,  a corporation  of  the  State  of  Michigan,  is 
and  has  been  for  several  years  past,  engaged,  under  a traffic  arrangement  with  the 
Canadian  Pacific  Railway  Company,  in  the  transportation  of  passengers,  on  through 
tickets  from  Quebec  westward  through  Canada  and  over  the  line  of  the  complainant’s 
railway  to  and  through  the  State  of  Michigan,  Wisconsin,  Minnesota  and  North  Dakota, 
also  eastward,  from  those  States,  through  Canada  to  Quebec,  a large  portion  of  the 
passengers  westward  being  persons  traveling  from  Norway  and  Sweden  to  points  in  said 
States. 

The  defendants,  it  is  averred,  constitute  the  State  Board  of  Health  of  Michigan,  act- 
ing under  an  act  passed  by  the  legislature  of  Said  State  and  approved  June  20th,  1885, 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


entitled  “An  act  to  provide  for  the  prevention  of  the  introduction  and  spread  of  cholera  \ 
and  other  ‘dangerous  communicable  diseases’”  as  amended  by  an  Act  approved  April 
25th,  1893.  The  bill  has  attached  to  it  as  exhibits  a copy  of  such  of  said  acts,  and  of  certain 
rules  adopted  by  said  Board,  purported  to  be  issued  under  and  by  virtue  of  the  author- 
ity conferred  by  said  amendatory  Act.  It  is  further  averred  that  said  Board  acting 
through  its  Secretary  and  one  of  its  inspectors  and  in  pursuance  of  said  rules,  is  daily 
detaining  and  attempting  to  detain  passengers  on  said  Canadian  Pacific  Railway  at  the 
point  opposite  Sault  Ste.  Marie,  Michigan,  and  prohibiting  their  entering  the  State  of 
Michigan  until  they  have  undergone  the  quarantine  detention  and  until  the  disinfec- 
tion of  their  baggage  as  prescribed  in  said  rules.  It  is  averred  that  this  detention, 
examination  and  process  of  disinfection  of  baggage  is  applied  to  all  emigrants  irrespec- 
tive of  whether  they  came  from  an  infected  or  healthy  locality  abroad  and  without 
regard  to  their  point  of  destination.  It  is  further  averred  that  all  said  emigrants  and 
travelers  have  been,  before  said  detention,  inspected  by  United  States  officials  detailed 
for  said  purpose  and  that  complainant  has  not  received  nor  permitted  to  be  conveyed 
within  the  State  of  Michigan  any  passenger,  traveler  or  emigrant  coming  from  any 
European  port  through  the  Dominion  of  Canada,  excepting  such  as  have  presented  a 
certificate  of  inspection  of  the  United  States  inspector.  It  is  also  averred  that  said 
Board  is  threatening  to  arrest  officials  and  employes  of  complainant  unless  complainant 
shall  submit  to  and  comply  with  said  requirements  of  said  Board 

The  claim  is  that  the  rules  and  action  of  said  Board  of  Health  are  in  direct  violation 
of  Section  8,  Article  1,  of  the  Constitution  of  the  United  States,  in  that  they  attempt  to 
regulate  and  prohibit  commerce  with  foreign  Nations;  and  that  they  are  also  in  viola- 
tion of  the  treaty  made  by  and  between  the  United  States  and  Norway  and  Sweden  and 
now  existing;  also  that  they  are  over,  above  and  beyond  the  powers  conferred  upon 
said  Board  by  said  Act  and  Amendatory  act  of  the  Legislature  of  Michigan.  The  bill 
then  sets  forth  averments  of  irreparable  damages  and  prays  for  an  injunction. 

The  motion  for  a preliminary  injunction  will  be  over-ruled  for  the  following  reasons: 

1.  In  Brown  vs.  Maryland,  12  Wheaton  419-433,  Chief  Justice  Marshall  recognized 
that  the  removal  or  destruction  of  infectious  or  unsound  articles  was  undoubtedly  an 
exercise  of  the  police  power  of  the  State,  and  an  exception  to  the  prohibition  resulting 
from  the  exclusive  power  of  Congress  to  regulate  the  operations  of  foreign  and  inter- 
state commerce,  and  he  says  that  “Laws  of  the  United  States  expressly  sanction  the 
Health  laws  of  the  State.”  In  the  license  cases  5 Howard,  504,  576,  Chief  Justice  Taney 
declares  that  “It  must  be  remembered  that  disease  pestilence  and  pauperism  are  not 
subjects  of  commerce,  although  sometimes  among  the  attendant  evils.  They  are  not 
things  to  be  regulated  and  trafficked  in,  but  to  be  prevented  as  far  as  human  foresight  ! 
or  human  means  can  guard  against  them.”  In  Ceatcher  vs.  Kentucky,  141  U.  S.  47; 
Justice  Bradley  refers  to  these  cases  with  approval,  and  states  with  great  clearness  and 
force  the  distinction  between  the  exercise  of  its  police  power  by  a State  and  an  attempt 
to  legislate  upon  matters  of  interstate  Or  foreign  commerce,  which  are  exclusively 
within  the  power  of  the  Federal  Government.  These  authorities  render  it  unnecessary 
to  refer  particularly  to  the  cases  cited  for  the  complainant.  It  is  sufficient  to  say  that 
they  all  relate  to  State  enactments  concerning  articles  of  commerce  and  thence  are  not 
applicable  here.  Moreover  the  Quarantine  Act  of  Congress,  approved  February  15, 
1893.  expressly  recognizes  the  validity  of  State  laws,  and  in  Section  3 requires  the 
Supervising  Surgeon  General  of  the  Marine  Hospital  Service  to  cooperate  with  and  aid 
State  and  Municipal  Boards  of  Health  in  the  execution  and  enforcement  of  their  rules 
and  regulations. 

2.  We  find  nothing  in  any  existing  treaty  with  Norway  and  Sweden  which  conflicts 
with  the  institution  or  enforcement  by  any  one  or  more  of  the  States  of  this  Union  of 
quarantine  regulations. 

3.  We  do  not  deem  it  necessary  to  express  an  opinion  whether  the  provision  of  the 
Michigan  Statute  making  it  a misdemeanor  to  violate  the  rules  of  the  State  Board  of 
Health  adopted  in  pursuance  of  the  Act,  is  constitutional  or  valid,  for  we  should  not, 
even  if  we  were  of  opinion  that  it  is  unconstitutional  undertake  to  issue  an  injunction 
against  Criminal  Prosecution  by  the  State.  That  the  Legislature  might  authorize  the 
Board  to  adopt  rules  is,  we  think,  beyond  question.  Such  rules  are  essential  to  the 
proper  enforcement  of  the  law. 

4.  To  the  objection  that  passengers  from  non-infected  countries  and  localities  are 
detained,  the  answer  is  that  such  detentions  are  in  the  nature  of  the  case,  to  a certain 
extent  unavoidable;  and  passengers  from  such  countries  and  localities  may  have  become 
properly  subject  to  detention  by  reason  of  having  mingled  with  others  who  could  com- 
municate pestilence  or  disease  to  which  they  themselves  had  been  exposed  or  subjected. 
An  opportunity  for  separation  is  indispensible  also. 

5.  The  objection  that  passengers  who  had  certificates  from  United  States  inspectors, 


ABSTRACT  OF  PROCEEDINGS,  SEPTEMBER  29-30,  1893. 


5 


were  detained,  is  not  tenable.  The  States  may  exercise  their  police  power  according  to 
their  own  discretion  and  by  means  of  their  own  officials  and  methods.  The  inconven- 
ience resulting  to  emigrants  and  travelers  from  being  halted  and  subjected  to  exam 
ination  and  detention  at  State  lines  is  of  trifling  importance,  at  a time  when  every 
effort  is  required  and  is  being  put  forth  to  prevent  the  introduction  and  spread  of 
pestilential  and  communicable  diseases. 

The  costs  and  charges  which  are  incurred  in  such  quarantine  inspection  may  lawfully 
be  imposed  on  the  Railway  Co.  as  being  incident  to  the  business  in  which  they  are 
engaged.  The  costs  of  the  motion  will  be  taxed  to  the  complainant. 

July  29th,  1893.  H.  F.  Severens. 

Geo.  R Sage. 

CONGRATULATORY  LETTERS  RELATIVE  TO  THE  U.  S.  COURT  DECISION. 

Copies  of  the  foregoing  decision  were  sent  to  Secretaries  of  State  Boards 
of  Health,  railroad  authorities,  and  others  interested  in  public  health  sub- 
jects, and  especially  in  this  case.  Letters  of  congratulation  have  been 
received  by  the  Secretary  of  the  Board,  and  extracts  from  a few  of  them 
are  as  follows  : 

Dr.  J.  H.  Hamilton,  Secretary  of  the  Vermont  State  Board  of  Health, 
writes:  “ Will  you  allow  me  to  congratulate  you  on  the  important  decision 
you  obtained,  not  only  for  your  Board  and  that  of  other  States,  but  for 
the  people  at  large.  I shall  make  use  of  this  decision  in  my  report  soon 
to  be  published.’ ’ 

E.  B.  Frazer,  M.  D.,  Secretary  of  the  Delaware  State  Board  of  Health, 
says:  “Your  Board  won  of  course . Railroad  companies  want  dollars — 
care  nothing  about  the  spread  of  diseases  and  the  loss  of  life.  I will  be 
pleased  to  hear  from  you  further  on  the  subject.  As  a rule  our  State 
courts  uphold  State  Boards  of  Health,  and  this  is  as  it  should  be.” 

N.  D.  Baker,  M.  D.,  Secretary  of  the  West  Virginia  State  Board  of 
Health,  says:  “You  have  conferred  a public  benefit  of  far-reaching  con- 
sequences in  thus  securing  so  unequivocal  a statement  of  the  rights  and 
powers  of  the  health  authorities  of  the  States.” 

It  is  undoubtedly  understood  that  all  that  was  done  by  the  State  Board 
of  Health  was  to  prepare  a statement  of  facts  bearing  upon  the  subject. 
Some  of  these  facts  are  very  interesting,  and  not  generally  known.  They 
may  be  published  later. 

OUTBREAKS  OF  DIPHTHERIA  IN  ALCONA,  HURON,  IOSCO  AND  SANILAC  COUNTIES, 
THE  CONTAGIUM  OF  WHICH  IS  ALLEGED  TO  HAVE  BEEN  FROM 
“CAMP  NO.  8”  IN  MILLEN  TOWNSHIP,  ALCONA  COUNTY. 

In  the  latter  part  of  May,  1893,  it  was  reported  to  the  Secretary  of  the 
State  Board  of  Health  that  a man  named  “ Corboski,”  who  had  been  work- 
ing at  a lumber  camp  in  Millen  towuship,  Alcona  county,  known  as  Loud 
& Sons’  “Camp  No.  8,”  was  taken  ill,  went  to  Oscoda,  and  died  within 
three  days  after  his  arrival  in  that  village.  The  cause  of  his  death  was 
given  as  “Ulcerative  Tonsilitis.”  Corboski’s  body  was  shipped,  immedi- 
ately after  his  death,  to  Paris  township,  Huron  county,  for  burial,  where  a 
“wake”  and  a public  funeral  were  held.  Several  families  of  persons  who 
had  attended  the  “wake”  and  funeral,  were  stricken  with  diphtheria. 
Outbreaks  of  the  disease  occurred  in  several  localities  in  Huron  and  Sani- 
lac counties  the  contagium  of  which  was  alleged  to  have  been  traced 
directly  or  indirectly  to  the  “ wake  ” and  funeral  over  the  body  of  Corboski. 

In  Alcona  county,  which  lies  north  of  Saginaw  Bay,  outbreaks  of  diph- 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


theria  occurred  in  several  townships,  the  contagium  of  which  was  alleged 
to  have  been  traced  to  “Camp  No.  8.” 

The  Secretary  of  the  State  Board  of  Health  was  in  constant  correspond- 
ence with  the  local  boards  of  health  of  the  several  infected  localities,  and 
urged  emphatically,  that  they  put  forth  every  effort  possible  to  stamp  out 
the  disease. 

The  health  officer  and  president  of  the  board  of  health  of  Millen  town- 
ship, in  which  “Camp  No.  8”  is  situated,  reported  that  no  cases  of  diph- 
theria had  occurred  in  their  jurisdiction. 

Bequests  were  received  from  local  boards  of  health  and  individuals  of 
seven  different  localities,  who  ascribed  the  cause  of  the  outbreaks  to  infec- 
tion from  the  camp  referred  to,  that  the  State  Board  investigate  the  sub- 
ject. In  compliance  with  such  request,  the  State  Board  employed  Dr.  J.  W. 
Hauxhurst,  of  West  Bay  City,  to  proceed  to  the  infected  localities  in 
Alcona  county,  and  endeavor  to  ascertain  the  cause  of  the  different  out- 
breaks of  the  disease.  After  his  investigation  he  reported  that  “Reliable 
and  undisputed  evidence  could  not  be  found  to  substantiate  the  statement 
that  diphtheria  originated  at  4 Camp  No.  8,’  nor  that  it  has  been  the  source 
whence  all  the  cases  in  ” the  several  townships  came.  “That  the  Corboski 
case  went  from  ‘ Camp  No.  8’  to  Oscoda,  died  there,  his  body  being  sent  to 
Huron  county,  has  not  been  denied.”  * * * “That  he  died  of  diph- 

theria is  not  at  all  doubtful.”  He  reported  that  three  other  men  who- 
worked  at  the  camp  referred  to,  went  to  their  homes,  had  diphtheria,  and 
died,  and  that  other  cases  occurred  in  their  families.  He  reports  that  he 
inspected  the  sanitary  conditions  of  “Camp  No.  8”  and  found  everything 
in  good  condition,  except  the  well  from  which  water  was  drawn  for  culi- 
nary and  laundry  purposes.  The  well  had  been  banked  up  with  manure 
to  prevent  the  pump  and  pipes  from  freezing,  and  that  water  percolated 
through  the  manure  into  the  water  in  the  well.  It  does  not  appear  from 
the  doctor’s  report  that  water  from  the  well  was  used  for  drinking,  but  it 
was  used  for  culinary  purposes.  There  is  no  evidence  that  it  contained  the 
germs  of  diphtheria,  or  that  if  diphtheria  was  there  it  was  spread  by  any 
other  than  the  common  mode — namely,  from  person  to  person.  He  also 
found  foulness  at  the  point  where  a drain  from  the  cook-room,  etc.,  dis- 
charged into  an  adjacent  swamp. 

The  following  table  shows  the  jurisdictions  into  which  diphtheria  was 
alleged  to  have  spread  from  “Camp  No.  8”  located  in  Millen  township, 
Alcona  county;  also  the  number  of  cases  and  deaths  which  have  been 
reported  from  each  jurisdiction,  up  to  Sept.  23,  1893.  In  the  majority  of 
instances,  the  outbreaks  have  been  reported  as  over  and  final  reports  sent 
in,  and  last  reports  from  the  other  localities  indicate  that  the  disease  has 
been  practically  eradicated. 


ABSTRACT  OF  PROCEEDINGS,  SEPTEMBER  29-30,  1893. 


T 


Counties  and  townships. 

Cases. 

00 

3 

c« 

a 

f [ *Harrisville  Tp 

19 

10 

j *Haynes  Tp. 

9 

3 

Alcona  Co.  ...  ■{  *Mikado  Tp 

1 

0 

j f Millen  Tp — 

0 

0 

L *Gustin  Tp._ 

9 

2 

“ Camp  No.  8,”  Alcona 

On.,  Millen  Tp.  -< 

f * Paris  Tp 

38 

16 

Huron  Co.  ^Bingham  Tp 

5 

2 

1 

L *Dwight  Tp 

7 

2 

( IGreenleaf  Tp. 

1 

0 

Sanilac  Co < 

( JMinden  Tp 

5 

2 

I Torch  Co.  *OfiCoda  Vil. 

m 

IT  1 

Total  CaHfiR  and  Daathfi 

95 

38 

* Infection  alleged  to  be  direct  from  “ Camp  No.  8.” 

t Health  officer  and  supervisor  of  Millen  township  will  not  admit  that  diphtheria  is  or  has  been  present 
in  “ Camp  No.  8.” 

± Secondary  infection  from  Paris  township. 

“ Corboski,”  whose  body  was  shipped  to  Paris  township,  and  conveyed  the  infection  to  the  counties- 
south  of  Saginaw  bay. 


SECRETARY’S  REPORT  OF  WORK  DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD  OF' 
HEALTH,  DURING  THE  QUARTER  ENDING  WITH  SEPTEMBER,  1893. 

Communicable  Diseases. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  dis- 
eases in  Michigan,  received  from  all  sources  and  filed,  and  the  corre- 
sponding number  concerning  which  action  was  taken  by  this  office  during 
the  quarter,  are  as  follows:  for  diphtheria,  142;  for  scarlet  fever,  134;  for 
typhoid  and  typho-malarial  fever,  135;  for  measles,  37.  Total  for  the 
five  diseases,  448. 

The  number  of  communications  relative  to  dangerous  communicable 
diseases,  received  and  placed  on  file  during  the  quarter,  was  1,768. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and 
demands  for  weekly  and  final  reports,  on  cards,  or  in  the  form  of  the  cir- 
cular letter,  were  sent  out  during  the  quarter  to  the  number  of  1,643. 

The  “ final  ” reports  of  outbreaks  received  and  filed  during  the  quarter, 
were:  for  diphtheria,  99;  scarlet  fever,  109;  typhoid  and  typho-malarial 
fever,  37 ; measles,  50.  Total  for  the  five  diseases,  295. 

During  the  quarter,  the  local  columns  of  newspapers  to  the  number  of' 
774,  have  been  looked  over  for  reports  of  occurrence  of  communicable 
diseases.  This  has  resulted  in  giving  this  office  information  of  the  alleged 
occurrence  of  16  outbreaks  of  diphtheria,  8 outbreaks  of  scarlet  fever,  15 
outbreaks  of  typhoid  and  typho-malarial  fever,  and  1 outbreak  of 
measles.  To  what  extent  the  reports  of  these  alleged  outbreaks  were 
verified,  is  shown  in  the  accompanying  table: 


s 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


TABLE  1.  -Showing  the  number  of  Outbreaks  of  Diphtheria , Scarlet  fever , Typhoid  fevr  and  Measles , 
from  July  1 to  Sept.  30,  1893,  of  which  notice  was  received  at  the  office  of  the  Michigan  State  Board  of 
Health;  the  per  cent  of  reports,  information  concerning  which  was  received  through  the  Newspapers; 
the  per  cent  of  newspaper  reports  which  were  confirmed  by  the  health  officer;  the  per  cent  of  newspaper 
reports  which  were  denied  by  the  health  officer ; and  the  per  cent  from  which  no  reply  was  received 
from  the  health  officer. 


Diseases. 

Reports 
from  all 
sources, 
July  1-Sept. 
30,  1893. 

Per  cent  of 
all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent  of 
newspaper 
reports 
which  were 
confirmed 
by  the  health 
officer. 

Per  cent  of 
newspaper 
reports 
which  were 
denied  by 
the  health 
officer. 

Per  cent  of 
newspaper 
reports  to 
which  the 
health  officer 
made  no  re- 
ply to  notice 
sent  from 
this  office. 

Diphtheria 

142 

11 

31 

H7 

31 

Scarlet  fever 

134 

6 

50 

25 

25 

Typhoid  fever 

135 

11 

20 

60 

20 

Measles 

37 

3 

100 

0 

0 

Averages  for  the  four  diseases. .. 

9 

33 

43 

25 

Compiling,  Editing,  Printing , etc.,  for  Publication. 

A compilation  of  reports  from  health  officers  and  clerks  has  been  made, 
and  the  article  relative  to  small-pox  in  Michigan  in  1890  has  been  written 
for  the  Annual  Report  for  1891 ; work  on  the  compilation  of  the  reports, 
etc.,  for  the  articles  on  Diphtheria  and  Scarlet  Fever  in  Michigan  in  1891, 
have  been  commenced.  The  article  on  Scarlet  Fever  in  Michigan  in  1890 
has  been  written  and  proved.  The  articles  on  Typhoid  Fever  and  on 
Nuisances  in  Michigan  in  1890  have  been  completed  for  the  printer.  The 
article  on  Small-pox  in  Michigan  in  1890  has  been  proved,  and  work  on 
the  proving  of  the  article  on  Measles  in  Michigan  in  1890  has  been 
commenced. 

Work  in  connection  with  the  printing  of  the  Annual  Report  for  1891 
has  been  continued.  Copy  has  been  prepared  for  the  printer,  and  the 
Proceedings  of  the  Stanton  Sanitary  Convention  has  been  printed  in 
pamphlet  form. 

The  article  “ Health  in  Michigan  ” for  the  new  edition  of  “ Michigan 
-and  Its  Resources,”  which  has  been  published  by  the  Secretary  of  State, 
has  been  revised,  and  additions  were  made. 

A pamphlet  “Names  and  Addresses  of  Health  Officers  in  Michigan  for 
the  year  1893-4,”  has  been  prepared  from  the  official  returns,  printed, 
and  distributed. 

Distribution  of  Publications,  etc. 

A copy  of  the  pamphlet  “ Names  and  Addresses  of  Health  Officers  in 
Michigan  for  the  year  1893-4,”  has  been  sent  to  each  of  1,260  health  officers 
whose  name  and  address  has  been  returned  to  this  office.  A copy  of  the 
pamphlet  has  been  marked  and  sent  to  each  delinquent  locality. 

Copies  of  the  Eighteenth  Annual  Report  of  this  Board,  to  the  number 
of  1,800,  have  been  sent  to  presidents  and  clerks  of  villages,  and  sanitarians 
in  this  and  other  States. 


ABSTRACT  OF  PROCEEDINGS,  SEPTEMBER  29-30,  1893. 


9 


About  the  usual  number  of  pamphlets,  on  the  Restriction  and  Preven- 
tion of  each  of  the  Dangerous  Communicable  Diseases,  has  been 
distributed  to  localities  where  dangerous  diseases  exist. 

Work  on  Meteorology . 

The  regular  tri-daily  meteorological  observations  have  been  continued 
at  this  Station,  and  a summary  for  each  week  and  month,  during  the 
quarter,  has  been  sent  to  the  Director  of  the  Michigan  Weather  Service 
and  Local  Forecast  Official  at  Detroit  for  his  use,  and  it  is  then  sent  by 
this  Official  at  Detroit  to  the  Chief  of  the  U.  S.  Weather  Bureau  at 
Washington. 

A supply  of  ozone  test-paper  for  the  months  of  Oct.,  Nov.  and  Dec.  was 
sent,  on  Sept.  15,  to  each  of  fifteen  meteorological  observers. 

Diagrams  for  the  Annual  Report  were  made  as  follows:  Nos.  ii.,  iii.,  iv., 
vi.,  vii.,  viii.,  ix.,  and  xi.,  illustrating  some  of  the  principal  meteorological 
conditions  in  Michigan  for  the  year  1891.  A diagram  of  “ Impure  source 
of  water  used  by  a person  who  contracted  typhoid  fever  in  Hartford, 
Michigan,”  and  a diagram  “ Deaths  from  Cholera  in  London  per  100,000 
persons  living  ” were  made.  This  last  is  to  illustrate  a paper  read  by 
Mr.  Willitts  at  the  Hillsdale  Sanitary  Convention. 

The  meteorological  tables  for  the  year  1892  have  been  made,  and 
meteorological  registers  for  Stations  in  Michigan  from  June  to  August, 
1893,  inclusive,  have  been  examined,  and  compilations  on  these  registers 
have  been  made,  with  the  exception  of  columns  relating  to  humidity  and 
atmospheric  pressure. 

Accessions  to  the  Library , etc. 

During  the  quarter  132  books  and  pamphlets,  and  256  numbers  of 
journals  (weeklies,  monthlies  and  semi-monthlies)  have  been  received  and 
entered  in  the  library  of  this  Board.  The  work  on  the  card  catalog  has 
been  continued. 

Correspondence , Hektograph  Work,  etc. 

During  the  quarter  1,676  pages  of  letter-book  have  been  used  in  copying 
the  correspondence  of  the  Office,  not  including  the  many  postal  cards  and 
circulars  which  have  been  sent  out  but  not  copied. 

More  than  the  usual  amount  of  hektograph  work  has  been  done,  due  to 
the  great  number  of  lists  of  immigrants  destined  to  settle  in  Michigan 
which  have  been  received  from  the  ports  of  debarkation,  and  from  the 
immigrant  inspectors  on  the  Michigan  border,  and  sent  from  this  office  to 
the  health  officers  of  the  localities  to  which  these  immigrants  were  going. 
About  1,747  pages  of  hektograph  work  have  been  made,  of  which  some 
190  pages  were  relative  to  the  opinion  of  the  U.  S.  Judges  in  the  case  of 
Minn.  St.  Paul  and  Sault  Ste.  Marie  R.  R.  vs.  State  Board  of  Health. 
Copies  of  the  opinion  were  sent  to  the  press  and  to  persons  interested  in 
the  subject. 


Work  in  Connection  with  Sickness  Statistics. 

During  the  third  quarter  of  1893,  1,755  blank  postal  report  cards,  125 
record  books,  35  printed  circulars  and  72  hektographed  circular  letters 
2 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


regarding  weekly  card  reports,  have  been  mailed,  in  packages,  to  122 
health  officers  and  regular  correspondents;  1,434  weekly  card-reports  have 
been  received  and  entered  on  the  register;  52  copies  of  the  hektographed 
weekly  bulletin  “ Health  in  Michigan  ” were  mailed  each  week,  and  101 
copies  of  the  monthly  bulletin  “ Health  in  Michigan  ” have  been  hekto- 
graphed and  mailed  each  month.  These  bulletins  have  been  consolidated 
for  this  quarterly  report.  Work  has  also  been  done  on  the  compilation  of 
the  weekly  card  reports  of  sickness  during  the  year  1891,  for  the  annual 
report  for  1892. 

Health  in  Michigan  in  the  third  quarter  of  1893.  Communicable 

Diseases. 

Compared  with  the  preceding  quarter,  (April,  May  and  June),  reports 
from  all  sources  show  diphtheria  to  have  decreased  by  an  average  of  one 
place,  scarlet  fever  to  have  decreased  by  an  average  of  eighteen  places, 
typhoid  fever  to  have  increased  by  an  average  of  thirty-five  places  and 
measles  to  have  decreased  by  an  average  of  thirty -five  places. 

Meteorology,  and  Sickness  from  all  Causes , third  quarter  of  1893,  Com- 
pared with  the  preceding  quarter. 

A comparison  of  meteorological  conditions  of  the  third  quarter  of  1893, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
prevailing  direction  of  the  wind  to  have  been  the  same  (southwest),  the 
average  velocity  26  per  cent  less,  the  temperature  10.83  degrees  higher, 
the  rainfall  at  Lansing  4.17  inches  less,  the  absolute  humidity  considerably 
more,  the  relative  humidity  slightly  less,  the  day,  and  the  night  ozone 
much  less,  and  the  hight  of  ground  above  the  water  in  the  well  at  Lansing 
to  have  been  2 inches  less. 

Compared  with  the  preceding  quarter,  (April,  May  and  June,)  the 
reports  from  regular  observers  show  a marked  increase  of  diarrhea  and 
inflammation  of  bowels,  and  a marked  decrease  of  influenza,  bronchitis 
and  inflammation  of  kidney  in  the  third  quarter  of  1893. 

The  Weather , and  the  Health  in  Michigan  in  the  third  quarter  of  1893 9 
compared  with  the  average  for  the  seven  years , 1886-1892. 

A comparison  of  the  meteorological  conditions  of  the  third  quarter  of 
1893,  with  the  average  for  the  third  quarters  in  the  seven  years,  1886-1892, 
showrs  that  in  1893,  the  prevailing  direction  of  the  wind  was  the  same, 
(southwest),  the  velocity  was  slightly  greater,  the  temperature  was  nearly 
the  same,  the  rainfall  at  Lansing  was  1.25  inches  less,  the  absolute  and  the 
relative  humidity  were  slightly  less,  the  day,  and  the  night  ozone  were 
considerably  less,  and  the  hight  of  ground  above  the  water  in  the  well  at 
Lansing  was  five  inches  less. 

Compared  with  the  average  in  the  corresponding  quarters  in  the  seven 
years,  1886-1892,  the  reports  received  from  regular  observers  indicate  that 
erysipelas,  intermittent  fever,  remittent  fever  and  consumption  were  less 
than  usually  prevalent,  and  that  no  disease  was  more  than  usually  preva- 
lent in  the  third  quarter  of  1893. 


ABSTRACT  OF  PROCEEDINGS 


OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


REGULAR  MEETING  JANUARY  12,  1894. 


[202.] 

A regular  meeting  of  the  Michigan  State  Board  of  Health  was  held  at 
Lansing,  Jan.  12,  1894.  The  members  present  were:  Hon.  Frank  Wells, 
President,  Lansing;  Prof.  Delos  Fall,  M.  S.,  Albion;  Mason  W.  Gray,  M. 
D.,  Pontiac;  and  Henry  B.  Baker,  Secretary.  The  absent  members  had 
notified  the  Secretary  that  they  would  be  unable  to  attend  this  regular 
meeting. 

The  regular  business  of  auditing  of  bills  and  accounts  was  transacted. 

ANALYSIS  OF  UNCONTAMINATED  SPRING  WATERS  IN  MICHIGAN. 

Prof.  Delos  Fall,  M.  S.,  of  Albion,  Committee  of  this  Board  on  Water 
Supply  and  Purification  of  Sewage-contaminated  Water,  made  a prelimin- 
ary report.  Prof.  Fall  has  undertaken  an  analysis  of  the  uncontaminated 
spring  waters  throughout  Michigan  in  order  to  ascertain  the  normal 
amount  of  chlorine.  Ten  parts  per  million  has  been  considered  the  max- 
imum amount  of  chlorine  which  should  be  found  in  good  water,  but  he 
thinks  that  the  standard  will  have  to  be  raised  somewhat  for  Michigan  as 
most  of  the  samples  that  he  has  examined  contain  over  ten  parts  of  chlor- 
ine per  million  parts  of  water.  Prof.  Fall  proposes  to  continue  these 
analyses  of  spring  waters  not  contaminated  by  leachings  from  barns, 
stables,  residences,  etc.  He  wants  a half  pint  of  such  water  in  a perfectly 
clean  bottle,  the  bottle  having  a new  cork,  and  the  sample  accompanied 
with  a reliable  statement  of  the  source  and  surrounding  conditions.  Prof. 
Fall  would  be  glad  to  receive  samples  of  such  spring  water,  and  would 
consider  it  a favor  if  any  person  interested  would  send  him  a sample,  the 
express  charges  to  be  paid  by  Prof.  Fall.  The  report,  which  Prof.  Fall 
will  make  to  this  Board,  will  be  looked  for  with  interest,  as  it  will  supply 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


one  standard  by  which  to  judge  of  the  extent  of  sewage  contamination  of 
waters  hereafter  examined  chemically.  . 

The  Board  voted  to  aid  Prof.  Fall  in  his  valuable  work  by  appropriating 
a small  sum  of  money  to  be  used  in  paying  expressage  on  samples  of 
water  sent  to  him. 

SANITARY  CONVENTION  AT  MENOMINEE,  MICHIGAN. 

The  Secretary  presented  an  invitation  from  the  leading  citizens  of  the 
city  of  Menominee,  requesting  the  State  Board  of  Health  to  hold  one  of 
its  Sanitary  Conventions  in  that  city. 

Thirty-nine  successful  Sanitary  Conventions  have  been  held  in  different 
parts  of  the  State  under  the  auspices  of  the  State  Board,  and  the  proposed 
convention  at  Menominee  will  be  the  fortieth.  These  conventions  have 
been  productive  of  much  good,  and  have  been  the  means  of  teaching  laige 
audiences  important  facts  in  every-day  sanitation  and  the  best  measures 
for  the  restriction  of  the  dangerous  communicable  diseases.  The  first 
Sanitary  Convention  was  held  in  Detroit  in  January,  1880. 

The  Board  appointed  Prof.  Fall  a committee  to  make  arrangements  for 
a Sanitary  Convention  at  Menominee. 


MICHIGAN  INSPECTION  OF  IMMIGRANTS  AND  TRAVELERS  DISCONTINUED. 

The  subject  of  the  further  continuance  of  the  Michigan  Inspection  of 
immigrants  was  discussed.  Secretary  Baker  thought  that  the  Michigan 
inspection  of  immigrants,  which  has  been  in  progress  for  some  time,  has 
done  much  to  prevent  the  introduction  aud  spread  of  dangerous  communi- 
cable diseases.  He  thought  also  that  the  stand  the  Michigan  State  Board 
had  taken  has  been  the  means  of  raising  the  standard  of  quarantine  in 
this  country,  tending  as  it  has  toward  the  disinfection  of  the  baggage  at 
all  immigrants  coming  into  this  country.  It  is  not  improbable,  that  the 
inspection  at  the  border  has  been  the  means  of  keeping  Michigan  tree 
from  small-pox,  and  it  is  probable  that  it  has  lessened  the  introduc- 
tion of  other  diseases.  The  Michigan  rules  for  disinfection  were  earned 
out  during  the  past  summer  at  Levis,  near  Quebec,  and  are  now  being 
carried  out  at  Halifax,  under  the  direction  of  Dr.  Wickwire,  Port  Health 
Officer  at  Halifax.  Small-pox  is  now  quite  prevalent  in  several  States,  but 
it  is  hoped  that  Michigan  will  not  be  visited  by  this  disease.  Owing  to 
the  depression  in  mining,  lumbering,  and  in  other  business,  immigration 
will  probably  be  much  lessened. 

The  recent  judicial  decision  was  discussed,  and  a resolution  was 
adopted,  as  follows: 

Resolved , That  in  view  of  the  adverse  decision  of  the  Hon.  Joseph  H.  Steere,  of  the  eleventh  Judicial 
Circuit,  declaring  the  penalty  portion  of  the  Michigan  quarantine  law  unconstitutional,  the  immigrant 
inspection  at  the  Michigan  border  is  hereby  suspended  from  and  after  January  13,  1894. 

It  is  understood  that  legal  measures  have  been  taken  to  obtain  a decis- 
ion on  this  subject  by  the  Supreme  Court. 


Brief  History  of  Action  Taken. 


Robert  Finch,  a railroad  agent  at  Sault  Ste.  Marie,  violated  and  contin- 
ued to  violate  the  Rules  of  the  State  Board  of  Health,  relative  to  the 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1894. 


3 


detention  and  disinfection  of  immigrant  baggage,  the  Rules  having  been 
made  under  Act  47,  Laws  of  1893.  Inspector  Rogers  made  complaint  to 
the  Justice  of  the  Peace,  and  asked  that  a warrant  for  the  arrest  of  Agent 
Finch  be  issued.  Justice  Frank  R.  Warner  refused  to  issue  the  warrant, 
holding  that  Act  47,  Laws  of  1893,  is  unconstitutional.  John  Hurst,  the 
Prosecuting  Attorney,  then  made  application  to  the  Circuit  Judge  to  see 
why  a peremptory  mandamus  should  not  issue  compelling  the  Justice  to 
issue  the  warrant  for  the  arrest  of  the  offender.  The  hearing  was  held 
before  Judge  Joseph  H.  Steere;  of  the  eleventh  judicial  circuit,  December 
8,  1893,  and  the  following  is  a copy  of  the  finding: 

Decision  by  Judge  Joseph  H.  Steere. 


State  of  Michigan.— In  the  Cibcuit  Court  fob  the  County  of  Chippewa. 


n 


John  Hubst,  Relator, 


YS. 


Mandamus. 


Frank  R.  Wabneb,  Respondent.  | 

J 

Application  for  writ  of  mandamus  to  compel  Frank  R.  Warner,  a Justice  of  the  Peace,  to  entertain 
criminal  complaint  and  to  proceed  with  the  trial  of  a case  sought  to  be  brought  for  violation  of  rules  pro- 
mulgated by  the  State  Board  of  Health  under  the  provisions  of  Act  No.  47  of  the  Session  Laws  of  1893. 

Statement  of  Issue. 

In  his  application  for  a mandamus  the  petitioner  sets  forth  that  on  November  28th,  1893,  he,  being  the 
Prosecuting  Attorney  of  Chippewa  county,  formerly  presented  a criminal  complaint,  made  under  oath 
and  in  writing,  to  the  Respondent,  who  was  a duly  qualified  Justice  of  the  Peace  of  said  county,  and  then 
and  there  asked  from  him  a warrant  for  the  arrest  of  one  Robert  B.  Finch,  who  was  charged  in  said  com- 
plaint with  violating  certain  rules  and  orders  of  the  Michigan  State  Board  of  Health; 

That  the  complaint  was  accompanied  by  an  order  from  the  Prosecuting  Attorney  for  a warrant,  and 
that  he  then  offered  to  produce  other  and  further  testimony  to  substantiate  the  complaint,  having 
witnesses  in  attendance  for  that  purpose. 

The  petitioner  further  alleges  that  said  justice  thereupon  refused  to  issue  a warrant  upon  said  complaint 
for  the  arrest  of  said  Robert  B.  Finch  and  persisted  in  so  doing,  and  gave  the  following  reasons  for  said 
refusal. 

1.  “ Because  Act  No.  230  of  the  Session  Laws  of  1885,  as  amended  by  Act  No.  47  of  the  Laws  of  1893,  of 
the  Legislature  of  this  State,  was  unconstitutional  and  void.” 

2.  “ Because  that  even  if  said  Act  was  not  void,  Rule  No.  2 of  the  Board  of  Health  of  said  State  of  Mich- 
igan, under  which  this  complaint  was  drawn,  was  not  authorized  by  said  Act  and  because  the  Board  of 
Health  exceeded  their  authority  in  passing  said  rule  No.  2,  and  that  he  did  not  wish  to  make  this  county 
any  unnecessary  expense  and  cost.” 

A copy  of  the  complaint  and  order  for  a warrant  are  attached  to  and  made  a part  of  the  petition. 

The  complaint  is  carefully  drawn  and  properly  states  an  offense  under  the  Statute  and  rules,  if  they  are 
valid. 

His  return  is,  in  substance,  a demurrer. 

In  his  answer  filed  in  response  to  the  order  to  show  cause,  he  admits  the  facts  stated  in  the  petition,  but 
alleges,  as  the  reasons  why  a mandamus  should  not  issue,  as  follows: 

“ That  the  Statute,  Act  No.  230  of  the  Laws  of  1885,  as  amended  by  Act  No.  47  of  the  Laws  of  1893  of  the 
State  of  Michigan,  under  which  the  rules  of  the  Board  of  Health  of  the  State  of  Michigan  are  adopted,  is 
unconstitutional  and  void  in  that  it  delegates  legislative  authority  to  an  appointive  board  and  assumes  to 
give  said  board  the  power  to  enact  rules,  a violation  of  which,  when  framed  and  published  (though  the 
manner  of  publication  is  not  prescribed)  is  made  an  offense  punishable  by  a fine  and  imprisonment,  and 
to  give  to  said  Board  the  further  power  to  change,  suspend,  revoke  and  re-enact  said  rules  whenever  cer- 
tain conditions  are  shown  to  the  satisfaction  of  said  Board  to  exist,  though  the  manner  in  which  the 
existence  of  such  conditions  is  to  be  shown  is  not  pointed  out.” 

The  respondent  further  alleges  that,  “ even  if  said  Statute  is  constitutional  and  valid,  Rule  No.  2 of  the 
said  Board  of  Health,  a copy  of  which  is  made  a part  of  this  answer,  for  a violation  of  which  said  com- 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


plaint  was  made  and  respondent  is  asked  to  issue  a warrant,  is  void,  for  the  reason  that  said  rule  is  not 
authorized  by  said  Act  No.  230  of  the  Laws  of  1885  as  amended  by  Act  No.  47  of  the  Laws  of  1893,  nor  by 
any  other  statute  of  the  State  of  Michigan,  and  that  for  these  reasons  this  respondent  should  not  be  com- 
pelled to  issue  a warrant  for  the  arrest  of  the  said  Robert  B.  Finch  upon  said  complaint.” 

Upon  this  issue  argument  was  had. 

Opinion- 

The  Mandamus  will  be  denied  for  the  reason  that  the  Statute  under  which  these  criminal  proceedings 
are  sought  to  be  brought  is  invalid  in  the  particular  that  it  seeks  to  delegate  to  a non-elective  subordi- 
nate board  legislative  powers  to  create  a misdemeanor,  and  is  in  violation  of  Sections  1 and  38  of  Article 
4 of  the  Constitution  of  the  State  of  Michigan. 

Section  1 of  said  Article  provides:  “The  legislative  power  is  vested  in  a Senate  and  House  of 
Repre  sen  tat  i ves . ” 

Section  38  of  said  Article  is  as  follows:  “The  Legislature  may  confer  upon  organized  townships, 
incorporated  townships  and  villages  and  upon  the  Board  of  Supervisors  of  the  several  counties  such 
powers  of  a local,  legislative,  and  administrative  character  as  they  may  deem  proper.” 

The  latter  article  is  clearly  a constitutional  limitation  defining  the  scope  within  which  the  Legis- 
islature  may  delegate  its  legislative  powers  to  subordinate  bodies.  The  State  Board  of  Health  is  not 
enumerated  among  those  bodies  to  which  this  power  can  be  delegated,  and,  by  implication  of  law,  is 
consequently  excluded  from  those  upon  whom  such  power  can  be  conferred.  / 

It  seems  clear  that  the  Legislature  cannot  confer  upon  the  State  Board  of  Health  any  legislative 
functions.  The  statute,  to  the  extent  that  it  assumes  to  do  so,  is  certainly  unconstitutional  and  void. 

3 Mich.,  343. 

29  Mich.,  460. 

24  Mich.,  108. 

Cooley  on  Constitutional  Limitations,  p.  139,  and  cases  cited. 

On  behalf  of  the  petitioner,  in  support  of  the  application  for  a mandamus,  it  is  contended  that  the  law 
does  not  delegate,  and  cannot  be  construed  as  attempting  to  delegate  any  legislative  power;  that  it  only 
authorizes  the  Board  to  make  rules  within  certain  well  defined  limits,  giving  it  no  discretion  to  declare 
penalties,  the  penalty  being  fixed  by  the  law  itself. 

Counsel  cites  to  statutes  clearly  constitutional  in  which  it  is  provided  that  an  officer  shall  give  notice 
to  do  or  not  to  do  a certain  thing,  on  failure  to  observe  which  notice  a person  shall  be  deemed  guilty  of 
the  misdemeanor,  etc.  Authority  is  also  cited  to  the  effect  that  it  is  not  delegated  power  to  be  author- 
ized to  determine  some  fact  or  condition  of  things  upon  which  the  law  makes  its  own  operations  depend. 

Locke’s  appeal,  72  Pa.  St.,  491. 

It  is  also  well  reasoned  that  there  are  many  things  upon  which  wise  legislation  depends  which  cannot 
be  known  to  the  law  making  power  and  must  therefore  be  suggested  afterward  and  determined  subse- 
quent to  the  enactment  of  the  law. 

This  argument  would  be  conclusive  if  the  scheme  of  the  statute  in  controversy  went  no  further  than  to 
authorize  the  Board  to  give  notice  to  do  or  not  to  do  certain  things  therein  stated,  or  to  determine  cer- 
tain facts  or  a certain  state  of  facts  set  forth  in  the  law,  and  upon  which  the  law  would  become  operative, 
but  it  seems  to  us  that  the  Legislature,  in  the  statute  in  question,  attempted  to  go  much  further.  The 
Board  is  first  authorized  to  determine  certain  facts  in  their  discretion  relative  to  passengers  and  baggage 
coming  from  infected  districts.  Then,  having  determined  those  facts,  it  is  further  authorized,  as  a dis- 
cretionary matter,  to  formulate  rules  upon  the  subject,  a violation  of  which  rules,  when  formulated  and 
published,  constitute  a misdemeanor  and  put  in  operation  the  criminal  laws  of  the  State  of  Michigan. 

Those  rules  may  involve,  and  as  formulated  do  involve,  certain  acts  and  conditions  of  things  which  are 
not  recited  in  the  statute,  a violation  of  which  constitute  a misdemeanor,  but  without  which  no  offense 
would  exist. 

We  have  no  doubt  of  the  authority  of  the  legislature  to  authorize  the  Board  to  adopt  rules  essential  to 
the  proper  administration  of  the  law,  involving  6uch  measures  as  may  be  necessary  to  enfore  those  rules, 
such  as  the  detention  of  a person  or  baggage,  preventing  their  entry  into  the  country,  and  perhaps  seiz- 
ure and  forfeiture  of  property.  But  we  don’t  think  that  misdemeanors  can  be  created  and  criminal  pro- 
secutions authorized  by  such  indirect  and  delegated  proceedings  as  those  contemplated  by  the  statute  in 
question.  Such  seems  to  be  the  view  taken  by  the  Supreme  Court  of  California  in  the  ex  parte  case  of 
John  Cox  on  Habeas  Corpus,  63  Cal.,  p.  21,  and  the  case  of  the  Board  of  Harbor  Commissioners  of  the 
Port  of  Eureka,  Appellant,  vs.  The  Excelsior  Redwood  Company,  Respondent,  88  Cal.,  p.  491. 

Our  attention  has  been  called  to  the  matters  discussed  in  the  case  of  the  Minneapolis,  St.  Paul  and 
Sault  Ste.  Marie  Ry.  Co.  against  the  State  Board  of  Health  of  Michigan,  decided  in  the  Circuit  Court  of 


ABSTRACT  OP  PROCEEDINGS,  JANUARY  12,  1894. 


5 


the  United  States  for  the  Western  District  of  Michigan,  northern  division,  decided  by  Judges  Severens 
and  Sage.  In  that  case  the  motion  for  a preliminary  injunction  was  overruled,  the  question  involved 
being,  mainly,  the  authority  of  the  States  to  enact  laws  and  provide  rules  relative  to  quarantine  matters, 
under  Section  8 of  Article  1 of  the  Constitution  of  the  United  States  and  certain  treaties  existing  between 
the  United  States  and  foreign  countries.  The  issues  decided  are  not  raised  in  the  case  at  bar,  and  the 
question  which  we  have  before  us,  though  referred  to,  was  not  decided  in  that  opinion,  the  Court  saying: 
“ We  do  not  deem  it  necessary  to  express  an  opinion  whether  the  provision  of  the  Michigan  Statute 
making  it  a misdemeanor  to  violate  the  rules  of  the  State  Board  of  Health  adopted  in  pursuance  of  the 
Act,  is  constitutional  or  valid,  for  we  should  not,  even  if  we  were  of  the  opinion  that  it  is  unconstitutional, 
undertake  to  issue  an  injunction  against  criminal  prosecution  by  the  State,”  leaving  the  question  before 
us  undetermined. 

Our  attention  is  called  to  the  fact  that  the  Federal  quarantine  laws  contain  provisions  for  the  promul- 
gation and  enforcement  of  rules  by  proper  officers,  and  that  those  rules  have  been  long  in  existence  and 
enforced  without  question. 

We  recognize  that  these  laws  and  rules,  with  the  usage  in  their  administration,  are  entitled  to  respect- 
ful consideration,  and  might,  in  a doubtful  case,  in  the  absence  of  other  authority,  though  not  binding 
in  the  interpretation  of  our  State  laws,  practically  control  a decision.  But,  after  a careful  examination 
of  the  laws  to  which  our  attention  is  called,  being  a pamphlet  issued  April  4, 1893,  by  the  Treasury  depart- 
ment, entitled  “ Laws  and  regulations  for  the  Maritime  Quarantines  of  the  United  States,”  we  fail  to 
there  find  any  authority  to  resort  to  criminal  procedure  to  enforce  the  quarantine  rules , or  anything  in 
the  statutes  making  the  violation  of  those  rules  a criminal  offense.  Violations  of  quarantine  laws  and 
misconduct  of  its  officers  are  made  criminal  offenses  punishable  by  heavy  penalties,  but  the  rules  are  to 
be  enforced  by  other  methods  such  as  the  exclusion  of  the  parties  who  fail  to  observe  them  from  entering 
the  country  or  importing  property,  or  by  the  seizure  and  detention  of  a person  or  property  for  a limited 
period,  or  the  seizure  and  forfeiture  of  property,  as  for  a violation  of  the  revenue  laws. 

We  fully  recognize,  with  Counsel  for  petitioner,  all  that  has  been  urged  relative  to  the  valuable  services 
which  the  Michigan  State  Board  of  Health  has  rendered  the  State,  and  the  difficulties  which  beset  it  in 
the  performance  of  its  duties.  We  cheerfully  endorse  all  which  has  been  6aid  as  to  the  importance  of 
rigid  quarantine  laws  to  protect  the  health  and  lives  of  our  citizens  from  the  importation  of  infectious 
diseases.  But  we  know  that  the  Courts  universally  recognize  that  the  State,  through  its  proper  legisla- 
tive body,  has  ample  power  to  go  to  extremes  in  the  enactment  of  rigid  laws  upon  the  subject,  and  to 
provide  heavy  pennlties  for  their  violation.  This  case  simply  involves  a constitutional  question  as  to 
the  method  of  getting  the  proper  provisions  upon  that  subject  in  legal  shape  for  their  enforcement.  It 
is  our  opinion  that  where  it  is  sought  to  make  a violation  of  any  quarantine  regulation  a crime,  the  legis- 
lature must,  by  its  own  enactment,  clearly  set  forth  the  facts  and  conditions  creating  the  offense  in  the 
statute  itself,  and  that  it  cannot  leave  the  question  open  for  subsequent  action  by  another  body,  and  del- 
egate the  authority  to  create  a misdemeanor,  as  has  been  attempted  in  the  statute  in  question. 

For  these  reasons  the  mandamus  is  denied  but,  inasmuch  as  this  is  a friendly  litigation,  carried  on  by 
all  parties  in  interest  in  good  faith  for  the  purpose  of  obtaining  a decision  upon  an  important  and 
doubtful  question,  the  decision  is  without  costs. 

Dated  December  18,  1893.  J.  H.  Steebe, 

Circuit  Judge. 

SCARLET  FEVER  AT  THE  SCHOOL  FOR  THE  DEAF,  AT  FLINT. 

Secretary  Baker  presented  and  read  a letter  dated  J anuary  11  which  he 
had  received  from  Mr.  F.  D.  Clarke  the  Superintendent  of  the  Michigan 
School  for  the  Deaf,  at  Flint.  Mr.  Clarke  said  that  although  he  had  the 
greatest  confidence  in  the  School’s  physician  and  the  city  board  of  health 
he  would  very  much  like  to  have  the  State  Board  of  Health  send  an  expert 
to  the  institution  to  aid  in  prevendng  the  spread  of  this  dangerous  disease. 
In  accordance  with  Mr.  Clarke’s  request,  the  Board  voted  to  send  Doctor 
John  W.  Hauxhurst  of  West  Bay  City,  who  had  several  times  acted  as 
expert  and  had  aided  localities  in  Michigan  in  preventing  the  spread  of 
dangerous  diseases. 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


PROPOSED  ESTABLISHMENT  OF  A CHAIR  OF  SANITARY  SCIENCE  AT  THE 
STATE  AGRICULTURAL  COLLEGE. 

In  a circular  letter  December  2,  the  Secretary  wrote  to  each  member  of 
the  State  Board  of  Health  that  “ An  opportunity  has  arisen  on  a subject 
which  I have  long  held  in  mind, — the  establishment  of  a chair  of  hygiene  at 
the  State  Agricultural  College,  and  I have  acted  promptly  for  myself,  but 
not  having  opportunity  to  consult  members  of  this  Board  I am  not  certain 
that  they  fully  concur  in  both  the  recommendations  in  my  memorial  to  the 
State  Board  of  Agriculture  (for  the  creation  of  a chair,  and  for  the  appoint- 
ment of  Prof.  Brewer)  so  I send  a copy  herewith,  and  ask  you  to  inform 
me  as  soon  as  practicable,  so  that  the  full  influence  of  this  Board  can  be 
exerted  so  far  as  members  of  the  Board  direct,  and  no  further.”  As  said 
in  the  foregoing  letter,  there  was  an  “ opportunity”  in  the  fact  that  the 
the  services  of  a good  man  could  be  secured  at  that  time;  an  opportunity 
which  had  not  presented  itself  before;  and  it  was  because  of  this  oppor- 
tunity that  the  Secretary  took  immediate  action,  thinking  that  if  the  right 
man  could  be  had,  the  probabilities  of  the  establishment  of  a chair  were 
greater  than  they  would  be  if  the  State  Board  of  Health  urged  the  estab- 
lishment of  the  chair,  but  could  not  provide  for  a man  to  fill  the  same.  Of 
course  the  State  Board  was  not  urging  that  any  individual  be  appointed, 
but  only  that  some  good  reliable  Professor  able  to  teach  modern  sanitary 
science,  be  called  to  fill  the  chair.  There  were  perhaps  others  who  would 
acceptably  fill  the  chair,  but  the  Secretary  had  not  before  had  the  oppor- 
tunity to  recommend  the  establishment  of  a professorship  and  at  the  same 
time  suggest  one  who  could  fill  it. 

The  following  is  a copy  of  the  memorial  which  had  been  prepared  by  the 
Secretary,  and  sent  to  the  members  of  this  State  Board.  So  far  as  it 
related  to  the  establishment  of  a chair  of  sanitary  science,  it  received  the 
approval  of  a majority  of  the  Board,  before  it  was  formally  placed  before 
the  State  Board  of  Agriculture  at  their  meeting,  at  Lansing,  December  4, 
1893.  Following  the  memorial  are  letters  which  the  Secretary  received 
from  the  members  of  the  State  Board  of  Health,  and  placed  before  the 
Board  of  Agriculture.  The  memorial  and  letters  are  as  follows: 

MEMORIAL  FOB  THE  ESTABLISHMENT  OF  A OHAIB  OF  HYGIENE  AT  THE  MICHIGAN  STATK  AGRICULTURAL 

COLLEGE. 

STATE  BOARD  OF  HEALTH,  MICHIGAN, 'i 
Office  of  the  Secretary,  > 

Lansing , December  1 , 1893.  ) 

To  the  Honorable , the  Michigan  State  Board  of  Agriculture : 

Gentlemen— Permit  me  to  memorialize  your  Honorable  Board  for  the  appointment  of  a Professor  of 
Hygiene  at  the  State  Agricultural  College,  and  to  suggest  a few  of  the  many  reasons  why  at  this  one  of 
the  most  important  colleges  in  Michigan,  the  teaching  of  Sanitary  science  should  be  prominent. 

A large  proportion  of  the  graduates  and  students  at  the  Agricultural  College  will  occupy  prominent 
positions  among  the  people  of  the  State,  being  leading  agriculturists,  horticulturists,  dairymen,  lawyers, 
teachers,  physicians,  and  business  men.  As  has  been  the  fact  in  the  past,  many  of  them  will  be  found  in 
the  State  Legislature,  framing  laws  for  the  government  of  the  whole  people.  It  is  for  the  general  good 
of  the  people  of  Michigan  that  these  leaders  of  thought  and  action  throughout  the  State  shall  be  well 
grounded  in  that  sort  of  knowledge  which  is  of  most  worth.  I presume  that  all  of  you  are  familiar  with 
the  result  of  that  inquiry  into  the  question— “ What  knowledge  is  of  most  worth?”  which  was  so  ably 
worked  out  by  that  great  philosopher  Herbert  Spencer,  in  his  book  on  “ Education.”  He  seems  to  have 
demonstrated  that  that  knowledge  is  of  “ most  worth  ” “ which  tends  directly  to  preserve  life;'”  and  that 
next,  in  the  scale  of  value,  is  that  knowledge  which  tends  indirectly  to  preserve  life,  leaving,  as  not  even 
of  secondary  importance,  many  of  the  branches  of  knowledge  so  frequently  taught  in  our  schools  and 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1894. 


7 


colleges.  Sanitary  science  includes  both  of  these  two  classes  of  knowledge  which  have  thus  been  dem- 
onstrated to  be  of  “ most  worth  ” and  as  of  next  most  worth,— that  class  of  knowledge  which  tends 
directly  to  preserve  life,  and  that  class  of  knowledge  which  tends  indirectly  to  preserve  life. 

It  is  understood  that  in  order  to  preserve  life  one  must  have  a means  of  earning  a livelihood;  but  means 
of  subsistance  have  advanced  so  rapidly  that  for  the  immediate  future  all  sorts  of  food  products  are 
cheap  and  plentiful. 

Sanitary  science  has  made  wonderful  progress  in  recent  years,  so  there  is  much  more  now  than  formerly 
that  is  positively  known,  and  which  can  be  taught  to  students.  There  are  now  many  well-developed 
branches  of  sanitary  science.  We  have,  therefore,  an  abundant  store  of  that  “ knowledge  which  is  of 
most  worth  ” which  is  now  available  to  the  teacher  of  hygiene.  That  knowledge  is  gradually  being  dis- 
seminated through  the  action  of  State  Boards  of  Health.  But  it  is  not  for  the  public  interests  that 
the  graduates  and  students  of  the  State  Agricultural  College,  who  are  to  be  among  the  leaders  of 
thought  and  action  throughout  the  State,  shall  be  merely  on  a level  with  the  common,  educated  peo- 
ple concerning  these  most  important  of  all  public  questions— relative  to  the  high  interests  of  human  health 
and  life.  Fortunately,  the  Michigan  State  Agricultural  College  has  among  its  professors  one  who  has- 
been  a leader  in  sanitary  progress— Prof.  R.  C.  Kedzie  has  been  president  of  the  State  Board  of  Health, 
and  president  of  the  American  Public  Health  Association,  and  much  of  value  in  a sanitary  way  is  taught 
by  Professor  Kedzie;  but  his  work  in  this  direction  is  necessarily  narrowed  by  the  requirements  of  his 
duties  as  Professor  of  Chemistry.  A similar  remark  applies  to  the  work  of  Prof.  F.  S.  Kedzie,  who  also 
has  given  much  attention  to  sanitary  subjects.  Prof.  Grange  has  given  attention  to  at  least  one  branch 
of  sanitary  science— bacteriology;  but  his  duties  as  Professor  of  Veterinary  science  and  practice  necessa- 
rily engross  his  attention. 

Permit  me  to  commend  to  you,  as  a Professor  of  Hygiene— Prof . F.  W.  Brewer,  who  for  the  past  year 
and  a half  has  been  Superintendent  of  the  Bureau  of  Hygiene  in  the  Department  of  Liberal  Arts,  at  the 
World’s  Columbian  Exposition,  who  previous  to  that  time  was  for  about  a year  employed  at  the  experi- 
ment station  of  the  State  University  of  Nebraska,  and  previous  to  that  was  an  Assistant  to  Prof.  Vaughan 
at  the  Michigan  University,  he  being  a graduate  of  the  Medical  Department  of  the  Michigan  University. 
A year  or  more  ago,  Prof.  Brewer  was  an  applicant  for  the  position  of  bacteriologist  at  the  Michigan  Agri- 
cultural College,  and  sent  testimonials  of  his  fitness  for  the  position.  I cannot  claim  personal  knowledge 
of  his  acquirements  in  bacteriology  or  in  other  branches  of  sanitary  science,  or  of  his  qualities  as  a 
teacher;  but  I can  claim  to  know  that  he  has  been  an  earnest  student  with  Prof.  Vaughan  at  our  Univer- 
sity, that  he  has  studied  the  Vital  Statistics  of  Michigan,  that  he  has  been  recommended  by  those  with 
whom  he  has  been  associated,  and  that  his  work  in  connection  with  the  World’s  Fair  has  brought  him  in 
contact  with  the  best  lines  of  sanitary  work  being  done  throughout  this  country,  and  some  of  that  being 
done  in  other  countries.  If  you  employ  him  as  a Professor  of  Hygiene  and  bacteriology,  you  will  have 
one  who  will,  I believe,  teach  bacteriology  not  only  with  reference  to  the  many  important  bearings  upon 
agriculture,  but  who  will  teach  it  also  with  reference  to  its  numerous  exceedingly  important  bearings 
upon  the  life  and  health  of  humanity;  one  who  will,  I believe,  teach  hygiene  not  as  it  was  before  the 
recent  great  progress,  but  as  it  has  been  enriched  by  the  wonderful  discoveries  of  Pasteur,  Koch,  Kitisato 
and  others. 

I hand  you  herewith  a letter  which  I have  received  from  Professor  Brewer,  and  a copy  of  a number  of 
commendatory  letters  relating  to  him. 

Hoping  that  your  Honorable  Board  will  appoint  some  person  to  the  important  position  of  Professor  of 
Hygiene,  and  commending  to  you  for  that  position  Professor  Brewer,  I am, 

Very  respectfully, 

Henry  B.  Baker. 

MICHIGAN  UNIVERSITY, 

Office  of  Dean  of  the  Medical  Department, 

Ann  Arbor,  Mich.,  December  2 , 1893. 

Dr.  Henry  B.  Baker,  Lansing,  Michigan : 

Dear  Doctor:— It  will  be  impossible  for  me  to  come  to  Lansing  next  Monday.  I should  be  glad  to 
to  do  so,  and  should  also  be  glad  to  do  anything  in  my  power  to  aid  in  the  establishment  of  a chair  of 
Hygiene  at  the  Agricultural  College,  and  I gladly  join  you  in  the  recommendation  of  my  old  friend  and 
former  student,  Doctor  Brewer,  for  a professorship  in  that  college.  Dr.  Brewer  was  my  assistant  for 
some  three  years,  and  I can  say  that  he  is  conscientious  and  skillful  in  his  work.  The  Agricultural  Col- 
lege can  make  no  mistake  in  establishing  a chair  of  Hygiene  and  in  calling  Dr.  Brewer  to  occupy  the 
same.  Yours  truly, 

Victor  C.  Vaughan. 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


STATE  BOARD  OF  HEALTH, 
Michigan, 

Grand  Rapids , Mich.,  Dec.  3,  1893. 

Dear  Doctor  Baker:— I most  heartily  commend  and  second  all  you  say  regarding  the  importance  of 
the  establishment  of  a chair  of  Sanitary  Science  in  our  Agricultural  College.  Indeed,  I was  surprised  to 
learn  that  heretofore  there  has  been  no  special  attention  given  to  that  subject  there.  In  such  an  institu- 
tion I think  it  would  be  much  more  important  to  have  a chair  in  Sanitary  or  Hygienic  Science  than  to 
have  a chair  of  Modern  Languages. 

As  to  the  recommendation  of  a particular  person  to  fill  such  chair,  it  may  be  deemed  inadvisable  for 
our  board  to  take  any  action,  although  personally  I would  be  willing  to  sanction  the  choice  of  yourself, 
or  Dr.  Vaughan.  Very  respectfully, 

S.  G.  Milner. 

STATE  BOARD  OF  HEALTH,  \ 
Michigan,  > 

Lansing , December  4,  1893.  ) 

Dr.  H.  B.  Baker,  Sec'y  State  Board  of  Health: 

Dear  Sir:— I am  in  hearty  sympathy  with  the  views  expressed  by  you,  relative  to  the  importance  of 
establishing  a chair  of  Hygiene  at  the  State  Agricultural  College  as  embodied  in  your  communication  to 
the  State  Board  of  Agriculture  under  date  of  Dec.  1.  The  knowledge  gained  during  the  last  twenty  years 
concerning  the  causes  of  all  communicable  diseases  and  the  means  for  their  prevention  is  second  to  no 
other  knowledge  of  this  marvelous  age,  in  its  influence  upon  human  life,  human  health  and  human  happi- 
ness. Such  being  the  case  it  would  seem  that  little  argument  should  be  necessary  to  convince  any 
thinking  person  that  this  knowledge  should  be  given  the  greatest  possible  publicity.  The  most  practical 
means  to  this  end  would  certainly  seem  to  be  the  employment  of  teachers  thoroughly  equipped  for  the 
work  in  all  our  institutions  of  learning.  While  its  rudiments  should  be  and  I doubt  not  soon  will  be 
taught  in  the  lower  grades  of  these  institutions,  our  common  schools,  yet  it  is  in  the  higher,  which  have  to 
do  with  youth  who  are  about  to  take  up  the  duties  of  citizenship  where  it  must  prove  of  the  greatest  value. 
The  Michigan  Agricultural  College  is  second  to  none  in  this  country  for  keeping  abreast  of  the  scientific 
investigations  of  our  day  and  of  impressing  them  upon  the  minds  of  its  graduates.  It  is  greatly  to  be 
hoped  that  the  new  and  valuable  facts  concerning  human  life  and  health  which  form  so  important  a sec- 
tion of  these  investigations  may  be  incorporated  into  its  curriculum.  I cannot  doubt  but  that  such  a step 
will  greatly  increase  its  efficiency  and  add  to  its  already  noble  reputation. 

Very  truly  yours, 

Frank  Wells, 

President  Mich.  State  Board  of  Health. 


STATE  BOARD  OF  HEALTH, 
Michigan, 

Pontiac,  December  5,  1893. 

Dr.  Henry  B.  Baker,  Secretary  of  the  State  Board  of  Health : 

My  Dear  Doctor:  - Your  letter  of  the  2nd  inst.  relative  to  the  establishment  of  a chair  of  hygiene  at  the 
Agricultural  College  and  the  appointment  of  Prof.  Brewer  to  the  chair,  was  received  yesterday,  but, 
owing  to  an  unusual  amount  of  work,  was  not  read  until  this  evening.  Of  course  this  reply  will  probably 
not  reach  you  as  soon  as  you  hoped  it  would,  but  I wish  to  say  that  I heartily  concur  in  everything  you 
say  in  your  memorial  to  the  Board  of  Agriculture.  Though  I know  Prof.  Brewer  only  by  reputation,  I 
believe  him  fully  qualified  for  the  important  place.  Very  truly  yours, 

Mason  W.  Gray. 

STATE  BOARD  OF  HEALTH, 
Michigan, 

Albion,  December  4,  1893. 

Dear  Dr.  Baker:— Your  letter  of  yesterday,  concerning  the  establishment  of  a chair  of  sanitary  science 
at  the  Agricultural  College,  is  at  hand.  It  seems  to  me  that  the  influence  of  the  Board  should  be  used  to 
the  fullest  extent  whenever  it  could  bring  about  such  a result,  not  alone  in  this  case  but  in  all  others. 
The  time  should  come  when  there  should  be  no  institution  of  any  grade  that  did  not  give  particular  atten- 
tion to  this  most  important  subject. 

As  to  the  Board’s  recommending  a special  candidate,  I am  not  so  clear ; you  can  do  it  personally,  and  I 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1894. 


9 


could  do  the  same,  but  we  should,  I fear,  bring  criticism  on  us  if  we  combine  in  any  particular  person’s 
interest.  I do  not  know  Prof.  Brewer,  but  you  do,  and  you  could  consistently  work  for  his  appointment. 

Yours  very  respectfully, 

Delos  Fall. 

SANITARY  SCIENCE  SHOULD  BE  TAUGHT  IN  MICHIGAN  LITERARY  COLLEGES. 

The  subject  of  a Chair  of  Sanitary  Science  at  the  State  Normal  School, 
and  at  the  State  Agricultural  College,  was  presented  by  Doctor  Baker.  He 
mentioned  that  the  State  Board  of  Agriculture  had  already  been  memo- 
rialized by  the  president  and  other  members  of  this  Board  and  himself,  to 
establish  a chair  of  hygiene;  but  he  thought  the  Board  as  a whole  should 
continue  to  exert  its  influence.  He  argued  that  the  State  law  compelled 
the  common  schools  of  Michigan  to  devote  time  to  the  teaching  of  hygiene, 
but  that  there  was  not  much  provision  for  the  proper  education  of  those 
teachers  who  are  compelled  to  teach  hygiene.  The  State  Normal  School 
is  devoted  to  the  training  and  education  of  teachers,  and  the  State  Agri- 
cultural College  has  its  vacation  in  the  winter,  in  order  that  its  students 
may  teach,  yet  neither  of  these  institutions  has  a chair  of  Sanitary 
Science.  The  State  Board  of  Health  had  already  put  forth  its  efforts  for 
such  a chair  at  the  Michigan  University,  and  a Laboratory  of  Hygiene  had 
been  established  and  is  now  doing  great  good.  Dr.  Baker  thought  that 
the  youngest  pupil  in  our  schools  should  have  an  idea  of  how  the  most 
dangerous  communicable  diseases  are  spread,  and  that  it  would  be  just  as 
practicable  to  teach  them  the  restrictive  measures,  as  it  is  to  teach  them 
all  about  the  bones,  muscles,  and  nerves,  as  is  now  attempted.  Each  pupil 
should  know  also  just  what  disease  causes  most  deaths  in  Michigan,  and 
just  how  it  may  be  prevented  or  avoided.  But  how  are  these  pupils  to  be 
taught  such  subjects,  when  there  is  practically  no  adequate  provision  for 
the  education  of  the  teachers? 

Dr.  Baker  said:  The  work  of  the  State  Board  of  Health  is,  to  a great 
extent,  educational;  and  it  is  effective  when  brought  to  bear  upon  the 
neighbors  of  a residence  placarded  for  a dangerous  disease.  Eventually 
every  part  of  the  State  is  thus  reached  by  its  instructions,  at  such  times  of 
especial  danger.  But  this  is  a slow  process;  and,  although  in  the  twenty 
years  of  the  work  of  the  State  Board  of  Health  the  death-rate  from  scarlet 
fever  has  been  reduced  at  least  one-half,  yet  the  statistics  prove  that  in 
those  localities  in  which  the  teachings  of  the  State  Board  have  been  wholly 
complied  with  by  the  people,  the  death-rate  has  been  not  more  than  one- 
sixth  what  it  was  where  this  has  not  been  done.  This  implies  that  if  this 
teaching  could,  in  some  way,  be  made  to  reach  every  locality  in  the  State, 
the  death-rate  should  be  reduced  by  five-sixths  instead  of  by  one-half. 
What  is  needed  for  the  greater  saving  of  life  from  scarlet  fever,  and  from  the 
other  dangerous  diseases, — because  the  same  principle  applies  to  them,  is 
the  proper  education  of  all  the  young  people  of  the  State.  The  State  laws 
require  that  Hygiene  shall  be  taught  in  all  the  schools.  But  how  is  it 
taught?  How  can  it  be  properly  taught  so  long  as  there  are  no  text-books 
which  teach  sanitary  science  as  it  is  taught  by  the  State  Board  of  Health, 
and  so  long  as  the  teachers  themselves  are  not  properly  prepared?  How 
can  the  teacher  be  properly  prepared? 

It  seems  plain  that  in  order  that  the  teachers  shall  be  properly  prepared, 
their  places  of  preparation  must  be  such  as  will  make  this  possible.  Many 
of  the  teachers  are  trained  for  their  work  at  the  State  Normal  School.  J.  E. 

2 


10 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


Hammond,  Deputy  Supt.  of  Public  Instruction,  says:  “ In  all  two  thou- 
sand two  hundrend  students  have  graduated  from  the  school,  besides  many 
others  who,  not  having  completed  the  course,  are  numbered  among  the 
progressive  teachers  of  the  State.  Michigan  is  justly  proud  of  the  work 
of  this  great  institution,  and  its  influence  is  felt  in  almost  every  village 
and  city  through  the  entire  State.’5  * 

The  State  Agricultural  College  also  is  a school  which  supplies  quite  a 
number  of  teachers,  the  college  vacation  being  in  the  winter  for  the  espec- 
ial purpose  of  permitting  the  students  to  teach. 

Prof.  Fall  said  he  was  very  glad  to  say  that  Albion  College  was  teaching 
Sanitary  Science.  A large  class  of  the  best  students  in  the  college  have 
this  course  of  training. 

On  motion  of  Prof.  Fall,  the  Board  voted  that  a committee  of  three  be 
appointed  by  the  President  to  memorialize  the  State  Board  of  Education 
to  establish  a Chair  of  Sanitary  Science  at  the  State  Normal  School.  Prof. 
Fall,  of  Albion,  Dr.  Baker,  and  Dr.  Milner,  of  Grand  Rapids  were  appointed 
to  act  as  this  committee. 

On  motion  of  Dr.  Baker,  it  was  voted  that  Dr.  Gray  of  Pontiac  act  as 
chairman  of  a committee  to  memorialize  the  State  Board  of  Agriculture  to 
establish  a Chair  of  Sanitary  Science  at  the  State  Agricultural  College.  It 
was  also  voted  that  President  Wells  and  Prof.  Vaughan  of  the  University 
be  the  other  members  of  this  committee. 

BURNING  OF  PEOPLE  IN  RAILWAY  WRECKS  MIGHT  BE  PREVENTED. 

During  this  quarter,  (Nov.  15,  1893),  the  State  Commissioner  of  Rail- 
roads referred  to  the  Secretary  of  the  State  Board  of  Health  a letter  which 
he  had  received  from  John  S.  Lorimer,  General  Storekeeper  of  the  Chi- 
cago and  Grand  Trunk  Railway,  relative  to  the  subject  of  hand  fire  extin- 
guishers on  railroad  coaches,  to  be  used  in  case  of  wrecks,  to  prevent  the 
burning  of  railway  coaches  loaded  with  human  beings,  as  occurred  recently 
in  the  fearful  accidents  at  Jackson  and  Battle  Creek  where  many  lives 
were  lost,  and  others  received  injuries  that  would  last  them  through  their 
lives. 

With  the  letter  of  Mr.  Lorimer,  the  Commissioner  of  Railroads  gave  to 
the  Secretary  of  the  State  Board  of  Health,  a circular  which  had  been 
sent  out  from  the  Commissioner’s  Office  in  which  was  urged  upon  General 
Managers  and  Superintendents  of  Railroads  the  importance  of  taking 
every  precaution  in  preventing  the  further  occurrence  of  accidents  on 
railroads  and  the  burning  alive  of  the  human  beings  intrusted  to  the 
railroads  for  safe  transportation.  The  Commissioner  urgently  recom- 
mended the  placing  of  hand  fire  extinguishers  in  all  railroad  coaches 
within  easy  reach  and  most  convenient  for  use,  the  use  of  oil  which  would 
stand  the  burning  test  of  300  degrees  or  more,  as  provided  by  the  statutes 
of  Michigan,  and  the  use  of  the  safest  known  pattern  of  car  heaters. 

After  carefully  reviewing  the  subject,  the  Secretary  of  the  State  Board 
of  Health  made  a report  to  the  Hon.  S.  R.  Billings,  State  Commissioner 
of  Railroads,  of  which  the  following  is  a copy: 

“Relative  to  the  question  asked  of  you  by  John  S.  Lorimer,  General 
Storekeeper  of  the  Chicago  and  Grand  Trunk  Railway,  in  his  letter  of 
Nov.  14,  referred  to  me  yesterday,  I can  report  that  the  State  Board  of 


“ Michigan  and  Its  Resources,”  “ 1893,”  page  137. 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1»94. 


11 


Health  has  not  recently  considered  the  exact  subject  of  hand  fire  extin- 
guishers for  use  on  passenger  trains;  but  some  years  ago  the  general 
subject  of  ‘The  Conditions  of  Inflammability’  was  very  thoroughly 
investigated  and  reported  upon  by  Prof.  E.  C.  Kedzie,  then  a member  of 
this  Board,  and  I take  pleasure  in  placing  that  report  before  you,  because 
it  will,  I think,  be  found  valuable  for  its  suggestiveness  in  relation  to  the 
subject  of  the  prevention  of  fires  on  wrecked  passenger  trains;  because  it 
is  probable  that  if  the  cars,  interior  fittings  and  contents,  could  be  made 
incombustible,  or  even  incapable  of  burning  with  a flame,  a great  part  of 
the  danger  from  fire,  would  be  done  away  with.  That  this  can  be  done  so 
far  as  relates  to  the  cars  and  fittings,  at  an  expense  which  would  be  justi- 
fiable, I have  no  doubt.  The  report  to  which  I refer  is  published  in  the 
Annual  Eeport  of  this  Board  for  the  year  1880.  I refer  especially  to 
pages  180-183. 

“ The  substances  which  can  be  applied  to  wood,  cloth,  paper,  etc.,  and 
thus  render  such  substances  incapable  of  burning  with  a flame,  are  com- 
mon, not  expensive,  and  are  numerous,  so  that  no  difficulty  should  be 
found  in  selecting  those  which  will  not  interfere  with  the  ornamentation 
of  the  car  or  its  fittings. 

“ In  complying  with  your  important  suggestion  that  ‘All  railroad  com- 
panies doing  passenger  business  in  this  State, — provide  all  eoaches,  baggage, 
express,  and  mail  cars  with  the  best  known  appliances  adapted  for  hand 
use,  to  extinguish  fire;  such  fire  extinguishers  to  be  placed  within  easy 
reach,  and  most  convenient  for  use,’  some  of  the  principles  set  forth  in 
Prof.  Kedzie’s  report  should  be  useful  to  the  storekeepers  for  the  several 
railroads.  In  that  report  a number  of  solutions  are  mentioned  which 
when  applied  to  wood- work,  cloth,  paper,  etc.,  render  such  articles  not 
easily  inflammable.  Solutions  to  be  kept  in  the  so-called  ‘ hand  grenades,’ 
for  extinguishing  fire,  must,  I suppose,  be  of  such  strength  that  they  will 
not  freeze  and  thus  break  the  glass  or  other  container;  but  I think  this 
is  easily  accomplished.  A saturated  solution  of  common  salt  would  not 
freeze,  and  would  be  a useful  article  in  such  ‘hand  grenades.’  But  it  is 
possible  that  there  are  substances  much  more  useful  than  that.  (Many  a 
soot  fire  in  a chimney  has  been  extinguished  with  a few  handfulls  of  com- 
mon salt.)  By  having  two  kinds  of  grenades  kept  for  use  together,  each 
to  break  into  the  other,  one  containing  a solution  of  a bicarbonate,  and 
the  other  a solution  of  an  acid  sulphate,  carbonic  acid  gas  could  be  liber- 
ated as  is  done  in  the  chemical  fire  engines,  on  a principle  similar  to  that 
of  the  ‘ Babcock  Fire  Extinguisher.’ 

“ If  desired,  I have  no  doubt  this  Board  would  have  a special  investi- 
gation made  to  ascertain  what  methods  would  be  most  feasible,  or  at  least 
what  scientific  principles  are  available.  If  you  wish,  I will  submit  the 
subject  to  the  Board  at  its  next  meeting. 

“ Herewith  I send  you  a copy  of  the  Eeport  of  this  Board  for  1880, 
containing  the  article  by  Prof.  Kedzie,  which  I have  mentioned. 

“ Very  respectfully, 

“ Henry  B.  Baker, 

“ Secretary .” 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


12 


The  Secretary  reported  that  he  had  mailed  to  each  member  of  the  Board 
a copy  of  the  revised  list  of  committees,  which  is  as  follows : 

STANDING  COMMITTEES  OF  MICHIGAN  STATE  BOARD  OF  HEALTH. 

Committees  as  re-arranged  and  adopted  by  the  Board,  Sept.  30,  1893.  Members  appointed  by  President- 
Frank  Wells,  October,  1893. 

1.  Epidemic,  endemic  and  communicable  diseases.— Victor  C.  Vaughan,  M.  D. 

2.  Sewerage,  and  the  disposal  of  excreta.— Mason  W.  Gray,  M.  D. 

3.  Water  supply,  including  purification  of  sewage— contaminated  water.— Prof.  Delos  Fall,  M.  S. 

4.  Buildings,  including  house  drainage,  ventilation,  heating,  etc.— Samuel  G.  Milner,  M.  D. 

5.  Climate,  geology,  topography,  and  drainage.— Henry  B.  Baker,  M.  D. 

6.  Food,  drinks  and  their  adulterations.— Victor  C.  Vaughan,  M.  D. 

7.  Poisons,  explosives,  etc. — Prof.  Delos  Fall,  M.  S. 

8.  School  hygiene  and  sanitation.— Samuel  G.  Milner,  M.  D. 

9.  Sanitary  inspections  in  cities  and  villages.— Prof.  Delos  Fall,  M.  S. 

10.  Statistics  of  mortality  and  sickness.— Henry  B.  Baker,  M.  D. 

11.  Public-health  legislation.— George  H.  Granger,  M.  D. 

12.  Finances  of  the  Board.— Hon.  Frank  Wells. 

13.  Animals’  diseases  dangerous  to  man.— Mason  W.  Gray,  M.  D. 

14.  Relations  of  preventable  sickness  to  taxation.— George  H.  Granger,  M.  D. 

15.  Quarantine  at  the  Michigan  border  and  within  the  State.— Hon.  Frank  Wells. 

SECRETARY’S  REPORT  OF  WORK  DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD  OF 
HEALTH,  DURING  THE  QUARTER  ENDING  WITH  DECEMBER,  1893. 

Communicable  Diseases. 

* 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  dis- 
eases in  Michigan,  received  from  all  sources  and  filed,  and  the  corre- 
sponding number  concerning  which  action  was  taken  by  this  office  during 
the  quarter,  are  as  follows:  for  diphtheria,  115;  for  scarlet  fever,  147;  for 
typhoid  and  typho-malarial  fever,  139;  for  measles,  18.  Total  for  the  four 
(or  five?)  diseases,  419. 

The  number  of  communications  relative  to  dangerous  communicable 
diseases,  received  and  placed  on  file  during  the  quarter,  was  1,913. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and 
demands  for  weekly  and  final  reports,  on  cards,  or  in  the  form  of  the  cir- 
cular letter,  were  sent  out  during  the  quarter  to  the  number  of  1,583. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  quarter, 
were:  for  diphtheria,  84;  scarlet  fever,  106;  typhoid  and  typho-malarial 
fever,  120;  measles,  11.  Total  for  the  five  diseases,  321. 

During  the  quarter,  the  local  columns  of  newspapers  to  the  number  of 
927,  have  been  looked  over  for  reports  of  occurrence  of  communicable 
diseases.  This  has  resulted  in  giving  this  office  information  of  the  alleged 
occurrence  of  10  outbreaks  of  diphtheria,  11  outbreaks  of  scarlet  fever,  31 
outbreaks  of  typhoid  and  typho-malarial  fever,  and  no  outbreak  of  measles. 
To  what  extent  the  reports  of  these  alleged  outbreaks  were  verified,  is- 
shown  in  the  accompanying  table: 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1894. 


13 


TABLE  1.— Showing  the  number  of  Outbreaks  of  Diphtheria,  Scarlet  fever,  Typhoid 
fever  and  Measles,  from  Oct.  1 to  Dec.  31,  1893,  of  which  notice  was  received  at  the 
office  of  the  Michigan  State  Board  of  Health;  the  per  cent  of  reports,  information 
concerning  which  was  received  through  the  Newspapers ; the  per  cent  of  newspaper 
reports  which  were  confirmed  bt/  the  health  officer:  the  per  cent  of  newspaper  reports 
which  were  denied  by  the  health  officer;  and  the  per  cent  relative  to  which  no 
reply  was  received  from  the  health  officer. 


Diseases. 

Reports  from 
nil  sources, 
Oct.  1 to  Dec. 
31,  1893. 

Per  cent  of 
all  reports 
which  were 
obtained  from 
the 

newspapers. 

Per  cent  of 
newspaper  re- 
ports which 
were  confirmed 
by  the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports which 
were  denied  by 
the  health 
officer. 

Per  cent  of 
newst  aper  re- 
ports to  which 
the  health 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria 

115 

9 

30 

50 

20 

Scarlet  fever 

147 

7 

45 

18 

36 

Typhoid  fever 

139 

22 

29 

42 

29 

Measles 

18 

0 

1 

0 

0 

0 

Averages  for  the  four  diseases  . . 

12 

38 

38 

29 

No  small-pox  has  occurred  in  Michigan  during  the  quarter. 

Small-pox  now  or  recently  in  other  States  and  Provinces. 

In  accordance  with  action  of  the  National  Conference  of  State  and 
Provincial  Boards  of  Health  at  Toronto,  1886,  and  Washington,  1887, 
“Inter-State  Notifications  of  Dangerous  Communicable  Diseases”  have 
been  received,  and  the  following  facts  learned  relative  to  small-pox  in 
other  States  and  Provinces:— 


State. 

Date  of  last  notice 

Cases. 

Deaths. 

Ohio _ 

October  24,  1893 

5 

Minnesota 

November  6,  “ . 

1 

Tennessee 

“ 9,  “ ... 

1 

West  Virginia 

“ 15,  “ 

1 

Illinois.. 

Indiana .. 

“ 25,  “ 

December  12,  “ 

158 

21 

Maine 

“ 13,  “ 

1 

Louisiana 

“ 30,  “ 

1 

Connecticut 

January  4,  1894 

6 

Massachusetts  .. 

“ 9,  “ 

47 

4 

Pennsylvania 

“ 11,  “ 

*710 

*18 

Prov.  Ontario 

“ 11,  “ 

5 

* These  cases  and  deaths  are  in  the  city  of  Beading,  Berks  Co.  Cases  are  also  reported  in  Berks  Co.  at 
Fnztown,  West  Leesport  and  Gibraltar,  and  at  Friedensburg,  Schuylkill  Co.  At  Mechanicsburg,  Cum- 
berland Co.,  ten  cases  and  one  death.  One  case  at  Carlisle,  Cumberland  Co.,  and  two  at  Willow  Grove, 
Allegheny  Co. 


3 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Summary  Relative  to  the  Year , 1893. 

Duriug  the  year  1893,  this  office  took  action  upon  1,881  outbreaks  of 
dangerous  communicable  diseases,  which  number  includes  540  outbreaks 
of  diphtheria,  674  outbreaks  of  scarlet  fever,  394  outbreaks  of  typhoid 
and  typo-malarial  fever,  271  outbreaks  of  measles,  and  2 outbreaks  of 
small-pox. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  etc., 
were  sent  out  during  the  year  to  the  number  of  6,705.  The  number  of 
communications  relative  to  such  diseases,  which  were  received  and  placed 
on  file  during  the  year  was  7,365. 

A record  is  kept  of  facts  concerning  every  outbreak  of  a “ disease  dan- 
gerous to  the  public  health,”  upon  which  action  is  taken  by  this  office, 
and  also  of  every  communication  relating  thereto  received  or  sent  out. 
This  required  over  14,000  entries  to  be  made  in  the  “ Record  Books,”  one 
of  which  books  is  kept  for  each  dangerous  communicable  disease. 

During  the  year  1893  compared  with  the  year  1892,  action  was  taken  on 
outbreaks  of  dangerous  commuicable  diseases  as  follows:  On  diphtheria, 
44  outbreaks  more;  scarlet  fever,  18  outbreaks  more;  on  typhoid  and  typho- 
malarial  fever,  10  outbreaks  more;  measles,  136  outbreaks  more;  and  small- 
pox, the  same  number  as  in  1892.  In  all  208  outbreaks  more  were  acted 
upon  in  1893  than  in  1892. 

(The  number  of  outbreaks  acted  upon  in  1893  was  almost  the  same  as 
in  1891.  The  number  in  1891  was  1,879,  in  1893  it  was  1,881. )' 


TABLE  2. — Showing  the  number  of  Outbreaks  of  Diphtheria,  Scarlet  Fever,  Typhoid 
fever  and  Measles,  from  January  1 to  December  31 , 1893,  of  which  notice  was 
received  at  the  office  of  the  Michigan  State  Board  of  Health ; the  per  cent  of 
reports , information  concerning  which  was  received  through  the  Newspapers;  the 
per  cent  of  newspaper  reports  which  were  confirmed  by  the  health  officer;  the  per 
cent  of  newspaper  reports  which  were  denied  by  the  health  officer,  and  the  per  cent 
relative  to  which  no  reply  was  received  from  the  health  officer. 


DISEASES. 

Reports  from 
all  sources. 
Jan  1-Dec. 
31,  1893. 

Per  cent  of  all 
reports  which 
were  obtained 
from  the  news- 
papers. 

Per  cent  of 
newspaper  re- 
ports which 
were  confirmed 
by  the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports which 
were  denied 
by  the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  health  offi- 
cer made  no 
reply  to  notice 
sent  from  this 
office. 

Diphtheria  

*540 

11 

28 

38 

39 

Scarlet  fever  

*674 

9 

45 

19 

35 

Typhoid  fever 

*394 

18 

80 

41 

30 

Measles 

*271 

10 

22 

8 

70 

Averages  for  the  four  Diseases 

12 

33 

30 

38 

* The  numbers  of  outbreaks  given  in  this  table  do  not  necessarily  agree  with  the  numbers  given  in  tables 
in  another  part  of  the  volume  inclnding  the  Annual  Report,  for  the  reason  that  all  alleged  outbreaks,  of 
which  information  was  obtained  from  the  newspapers  and  other  sources  are  included  in  this  table.  If 
the  health  officers  denied  that  such  outbreaks  occurred,  or  if  they  make  no  response  to  the  letters 
sent  from  this  office,  relative  to  newspaper  reports,  such  alleged  outbreaks  are  not  included  in  the  com- 
pilation of  that  disease. 


ABSTRACT  OP  PROCEEDINGS,  JANUARY  12,  1894. 


15 


During  the  year,  the  local  columns  of  newspapers  to  the  number  of 
3,441  have  been  looked  over  for'  reports  of  the  occurrence  of  dangerous 
communicable  diseases.  This  has  resulted  in  giving  this  office  informa- 
tion of  the  alleged  occurrence  of  61  outbreaks  of  diphtheria,  62  outbreaks 
of  scarlet  fever,  71  outbreaks  of  typhoid  and  typho-malarial  fever,  and 
27  outbreaks  of  measles.  To  what  extent  the  reports  of  these  alleged 
outbreaks  of  the  five  diseases  were  verified  during  the  year,  is  shown  in 
the  accompanying  table. 

Small-pox  in  Michigan  in  1893. 

Ten  cases  of,  and  three  deaths  from  small-pox,  were  reported  to  this 
office  during  the  year  1893.  There  were  two  outbreaks  of  the  disease,  both 
during  the  month  of  January;  one  occurred  in  the  township  of  Springport, 
Jackson  county,  which  was  confined  to  the  first  case;  the  patient  was 
exposed  to  the  disease  at  Akron,  Ohio,  where  the  disease  prevailed  to  a 
considerable  extent  during  December,  1892,  and  January,  1893.  The 
second  outbreak  occurred  in  Pittsfield  township,  Washtenaw  county,  dur- 
ing which  9 cases  and  3 deaths  occurred.  The  contagium  of  the  disease 
was  brought  into  that  locality  by  a family  of  German  immigrants,  named 
“ Jagar,”  which  “ came  to  this  country  on  the  steamer  ‘ Saale,’  about  Dec. 
1,  1892.”  It  is  alleged  that  small-pox  “ broke  out  on  the  vessel  and  the 
infected  passengers  were  allowed  to  scatter  all  over  the  country.”  (Quota- 
tions from  a letter,  dated  March  4,  1893,  to  Gov.  Rich,  from  the  health 
officer  of  Pittsfield  township.) 

There  is  good  reason  to  believe  that  infected  persons  from  the  same 
vessel  were  responsible  for  the  outbreak  of  small-pox  at  Akron,  Ohio,  in 
which  41  cases  and  9 deaths  had  already  occurred  Jan.  31,  1893,  and 
from  which  place  the  infection  was  carried  to  Springport  township,  Jackson 
county,  Mich.,  and  caused  the  outbreak  referred  to  above. 

Two  cases  in  and  near  to  Cincinnati,  Ohio,  occurred  in  January,  1893. 
Relative  to  these  cases,  Dr.  Probst,  the  Secretary  of  the  Ohio  State  Board 
of  Health,  says:  “ Cincinnati  and  Norwood  cases  are  German  immigrants, 
arrived  on  ship  ‘ Saale,’  via  New  York.” 

Alleged  Hydrophobia  in  Michigan  in  1893. 

Two  deaths  from  alleged  hydrophobia  occurred  during  the  year,  1893. 
One,  a young  lady  residing  in  the  village  of  Deerfield,  Lenawee  county, 
was  taken  ill  June  24,  and  died  June  26,  1893.  Dr.  Bliss,  the  village 
health  officer,  wrote  that  the  lady  “ was  bitten  by  a rabid  dog,  about  the 
middle  of  April.”  In  reply  to  an  inquiry  from  this  office  relative  to  what 
disposition  was  made  of  the  dog,  the  health  officer  says:  “ So  far  as  regards 
the  dog  that  bit  Miss  Burnham,  nothing  is  known.  He  has  not  been  seen 
or  heard  from  since  the  day  that  he  bit  her.” 

The  second  death  from  alleged  hydrophobia  occurred  in  Olive  township, 
Clinton  county,  on  the  16th  day  of  Aug.  1893.  Dr.  Wiggins  of  St.  Johns, 
who  was  the  attending  physician,  says:  “ I treated  Mr.  H.  about  two  weeks 
just  before  and  up  to  his  death.  Up  to  the  second  week  I was  unable  to 
make  a diagnosis  satisfactory  to  myself.  I was  then  told  that  in  March 
last  he  was  bitten  on  his  right  hand  (index  finger)  by  a young  hog,  while 
trying  to  give  it  medicine.  The  animal  died  soon  after,  of  what  was 
thought  to  be  hog  cholera.  There  was  no  suspicion  of  rabies  attached  to 


16 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


the  hog,  nor  was  it  known  that  it  had  ever  been  bitten  by  any  other 
animal.  Before  this  case,  I had  treated  three  other  cases  of  hydrophobia. 
One  person  was  bitten  by  a skunk,  another  by  a dog  while  trying  to  part 
two  dogs  in  a fight,  and  the  third,  a child,  bitten  by  a kitten.  The 
first  patient  made  the  peculiar  squall  of  a skunk;  the  second  barked,  and 
the  child  would  mew  like  a kitten,  and  Mr.  Huntoon  grunted  and  snorted 
like  a hog.  His  was  a pronounced  and  well  marked  case  of  violent  hydro- 
phobia. Another  proof  of  this  fact  was  his  great  aversion  to  the  use  of 
water,  or  the  presence  of  it,  and  further,  he  at  no  time  lost  the  control  of 
his  mental  faculties.  When  he  felt  his  paroxysms  approaching,  he  would 
request  that  he  be  tied  or  confined,  saying,  he  feared  he  might  hurt  those 
around  him. 

“Mr.  Huntoon  was  about  56  years  of  age,  of  good  constitution  and  health, 
up  to  about  three  weeks  before  his  death.” 

Alleged  Cholera  in  Michigan  in  1893. 

Aug.  3,  1893,  an  “outbreak  report”  relative  to  “a  case  of  supposed 
cholera”  was  received  from  the  clerk  of  Calvin  township,  Cass  county.  A 
letter  was  sent  at  once  to  the  health  officer,  requesting  that  precautionary 
measures  be  taken  to  restrict  the  spread  of  the  disease,  and  asking  that,  if 
the  disease  was  really  Asiatic  cholera,  the  facts  be  telegraphed  to  this 
office  without  delay. 

A letter  of  similar  import  was  sent  to  the  clerk  of  the  township,  asking 
whether  the  patient  was  an  immigrant,  and  if  so,  where  he  came  from 
and  by  what  ship,  and  when  he  arrived  in  this  country.  Also  asking  for 
the  name  and  address  of  the  attending  physician.  A prompt  reply  was 
asked  for. 

Pamphlets  on  the  restriction  and  prevention  of  cholera  were  sent  to  the 
health  officer  and  clerk,  for  their  own  instruction  and  for  distribution. 

After  some  delay  on  the  part  of  the  health  officer  and  clerk,  it  was 
learned  that  the  name  of  the  attending  physician  was  John  A.  Harris, 
postoffice,  Day,  Mich.  A letter  was  at  once  sent  to  the  physician  request- 
ing a description  of  the  symptoms  of  the  disease,  and  asking  if  any  exam- 
ination had  been  made  after  death,  to  learn  the  true  nature  of  the  disease. 
No  response  was  received  to  that  request. 

The  patient  was  reported  to  have  died  within  twenty-four  hours  after 
first  attack.  He  came  from  South  Bend,  Indiana,  two  days  before  being 
taken  sick.  He  was  not  an  immigrant,  and  it  could  not  be  learned  that  he 
had  been  exposed  to  cholera. 

Relative  to  precautions  taken  to  prevent  the  spread  of  the  disease,  the 
health  officer  reported  that  the  burial  was  “private,”  that  “those  that 
were  at  the  house,  were  kept  there,  those  that  had  gone  home,  were  quaran- 
tined at  their  homes.”  That  all  of  the  rooms  in  the  house  and  the  privy 
were  disinfected  with  the  fumes  of  burning  sulphur,  five  pounds  having 
been  used  for  the  purpose.  He  reported  that  the  discharges  of  the  patient 
were  disinfected  with  chloride  of  lime  and  then  buried. 

Compiling , Editing , Proof-reading , Printing , etc. 

A compilation  of  the  reports  from  health  officers  and  clerks  has  been 
made,  the  compilation  proved,  and  the  article  relative  to  Scarlet  Fever  in 
Michigan  in  1891  has  been  commenced;  the  compilation  of  reports  from 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1894. 


17 


health  officers  and  clerks  relating  to  Typhoid  Fever  in  Michigan  in  1891, 
has  been  commenced;  the  work  in  connection  with  proving  and  writing  the 
article  relative  to  Measles  in  Michigan  in  1890  has  been  completed;  the 
compilation  relative  to  Diphtheria  in  Michigan  in  1891  has  been  made  and 
about  half  proved. 

Articles  relative  to  Typhoid  Fever,  Whooping-cough,  Consumption,  Glan- 
ders, Hydrophobia,  Anthrax,  Lump-jaw,  Tyrotoxicon,  Injuries,  and  Loss 
of  Life  and  Property  in  Michigan  from  the  use  of  Kerosene,  Gasoline  and 
Naphtha,  and  Alleged  Nuisances  in  Michigan,  for  the  Annual  Report  of  the 
State  Board  of  Health  for  the  year  1891,  have  b°en  written,  proof  has  been 
read  in  this  Office,  and  the  articles  have  been  printed. 

Proof  has  been  read  on  the  Proceedings  of  the  Sanitary  Conventions 
held  under  the  auspices  of  this  Board  at  Stanton  and  at  Hillsdale. 

The  printing  of  the  Annual  Report  of  the  Secretary  of  the  State  Board 
of  Health  for  the  fiscal  year  ending  June  30,  1891,  has  been  nearly  com- 
pleted. The  indexing  of  this  Report  is  nearly  completed. 

A statement  of  the  Cases  and  Deaths  from  Diphtheria,  Scarlet  Fever, 
Typhoid  Fever,  Measles,  and  Whooping-cough  in  Michigan  in  1892,  has 
been  made  from  the  annual  report  blanks  from  health  officers  and  clerks 
of  townships,  cities  and  villages  in  Michigan. 

Distribution  of  Publications , etc. 

The  Proceedings  of  the  Sanitary  Convention  held  at  Stanton  has  been 
sent  to  the  Officers  and  participants  of  the  Convention,  Members  and  Ex- 
Members  of  this  Board,  Secretaries  of  State  Boards  of  Health  and  of  State 
Medical  Societies  of  other  States,  Sanitarians  of  this  and  other  States,  and 
other  persons  interested  in  Sanitary  work,  to  the  number  of  about  1,100 
copies.  At  the  same  time  the  Resolution  of  this  Board  relative  to  Con- 
sumption being  a “ Disease  dangerous  to  the  Public  Health,”  was  also 
sent  to  the  foregoing-named  persons,  and  has  been  widely  distributed  else- 
where to  the  number  of  about  three  thousand  copies. 

During  the  quarter  1,571  envelopes  were  directed  to  health  officers  of 
townships,  cities  and  villages,  and  about  the  same  number  (1,570)  of 
envelopes  were  directed  to  clerks  of  townships,  cities  and  villages.  These 
envelopes  are  to  be  used  in  sending  to  each  clerk  and  health  officer  in 
Michigan  blank  forms  for  making  annual  reports  of  “ Diseases  dangerous 
to  the  Public  Health”  during  the  year  1893.  Each  health  officer  and  each 
clerk  also  receives,  with  each  set  of  blanks,  a circular  letter  giving  instruc- 
tions for  making  out  the  annual  reports,  etc.  Although  the  blanks  were 
printed,  the  envelopes  addressed  and  filled  with  the  annual  report  blanks 
and  letter  of  instruction,  there  was  time  only  to  send  the  supplies  to  363 
health  officers  and  362  clerks  of  cities  and  villages.  The  supplies  to  health 
officers  and  clerks  of  townships  will  be  sent  immediately  after  Jan.  1,  1894. 

About  the  usual  number  of  pamphlets  relating  to  the  restriction  and 
prevention  of  the  different  dangerous  communicable  diseases,  were  dis- 
tributed to  health  officers  of  localities  where  dangerous  diseases  were 
reported.  It  was  requested  at  the  same-  time  that  these  pamphlets  be  dis- 
tributed to  the  neighbors  of  the  persons  sick  with  such  dangerous  disease. 

Correspondence , Hektograph  work , etc. 

During  the  quarter,  1,061  pages  of  letter-book  have  been  used  in  copy- 
ing the  correspondence  of  the  Office,  not  including  many  postal  cards  and 
circulars  which  were  sent  out  but  not  copied  in  the  letter-book. 


18 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


About  1,728  pages  of  hektograph  work  have  been  made,  of  which  150 
pages  were  relative  to  the  special  meeting  of  the  Board  October  27  and  28, 
1893;  270  pages  were  relative  to  the  Dangerous  Location  of  Consumptives, 
as  reported  to  this  office  by  Dr.  Myron  Briggs,  health  officer  of  Speaker 
Township,  Sanilac  county,  and  200  pages  were  relative  to  the  opinion  of 
Judge  Steere,  in  the  case  of  Hurst  vs.  Warner.  The  hecktograph  work  is 
slightly  less  than  the  preceding  quarter,  owing  to  the  change  in  the  man- 
ner of  sending  out  immigrant  notices,  which  are  now  mostly  sent  on  blank 
forms  for  that  purpose. 

Work  on  Meteorology . 

The  regular  tri-daily  meteorological  observations  have  been  continued 
at  this  Station,  and  a summary  for  each  week  and  month  during  the 
quarter  has  been  made  for  use  in  this  office,  in  connection  with  sickness 
reports.  The  monthly  summary  has  been  sent,  at  the  end  of  each  month, 
to  the  Director  of  the  Michigan  Weather  Service  and  Local  Forecast 
Official  at  Detroit,  for  his  use,  and  is  then  sent  by  him  to  the  Chief  of 
the  U.  S.  Weather  Bureau,  at  Washington,  D.  C. 

On  December  16,  1893,  meteoroligical  blank  registers,  envelopes,  postal 
cards,  ozone-test  paper,  etc.,  were  sent  to  meteorological  observers  for  the 
State  Board  of  Health,  for  their  use  during  the  year  1894. 

Diagrams  for  the  Annual  Report  for  the  year  1892,  were  made  as  fol- 
lows: Nos.  xvi.,  x.,  v.,  xii.,  xiv.,  xv.,  illustrating  some  of  the  principal 
meteorological  conditions  in  Michigan  for  the  year  1891;  Nos.  1,  2,  3,  4 
and  5 to  be  used  in  the  article  “Time  of  Greatest  Prevalence  of  Each 
Disease  in  Michigan,  in  189 1 ;”  and  a Diagrammatic  “ Map  showing  location 
and  order  of  occurrence  of  Sanitary  Conventions  held  in  Michigan.”  This 
last-named  diagram  or  map  accompanies  Prof.  Fall’s  paper  on  “ Sanitary 
Conventions  in  Michigan,”  which  was  read  before  the  National  Conference 
of  State  and  Provincial  Boards  of  Health,  at  Lansing,  June  6,  1892.  A 
diagram  showing  the  “ Reported  Deaths  from  Measles  in  Michigan  during 
each  year  1868-91  ” was  also  made  and  has  been  printed  in  connection 
with  the  article  relative  to  measles  in  the  Annual  Report  for  1891. 

Accessions  to  the  Library , etc. 

During  the  quarter,  84  books  and  pamphlets  and  309  numbers  of  journ- 
als (weeklies,  monthlies  and  quarterlies),  have  been  received  and  entered 
in  the  library  of  this  Board.  The  work  on  the  card-catalogue  of  the 
books  and  pamphlets  has  been  continued. 

Work  in  connection  with  Sickness  Statistics. 

During  the  fourth  quarter  of  1893,  1,725  blank  postal  report  cards,  126 
record  books  and  34  hektographed  circular  letters  regarding  weekly  card- 
reports,  have  been  mailed,  in  packages,  to  119  health  officers  and  regular 
correspondents;  1,474  weekly  card-reports  have  been  received  and  entered 
on  the  register;  53  copies  of  the  hektographed  weekly  bulletin  “Health 
in  Michigan”  were  mailed  each  week,  and  110  copies  of  the  monthly 
bulletin  “ Health  in  Michigan”  have  been  hektographed  and  mailed  each 
month.  These  bulletins  have  been  consolidated  for  this  quarterly  report. 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  12,  1894. 


19 


Work  has  also  been  done  on  the  compilation  of  the  weekly  card  reports  of 
sickness  during  the  year  1892,  for  the  annual  report  for  1893. 

Health  in  Michigan  in  the  fourth  quarter  of  1893.  Communicable 

Diseases. 

Compared  with  the  preceding  quarter,  (July,  August  and  September), 
reports  from  all  sources  show  diphtheria  to  have  decreased  by  an  average 
of  six  places,  scarlet  fever  to  have  increased  by  an  average  of  fourteen 
places,  typhoid  fever  to  have  increased  by  an  average  of  nineteen  places 
and  measles  to  have  decreased  by  an  average  of  fifteen  places. 

Meteorology  and  Sickness  from  all  Causes , fourth  quarter  of  1893 , 
Compared  with  the  preceding  quarter. 

A comparison  of  meteorological  conditions  of  the  fourth  quarter  of 
1893,  with  the  meteorological  conditions  of  the  preceding  quarter,  shows 
the  prevailing  direction  of  the  wind  to  have  been  the  same  (southwest), 
the  average  velocity  42  per  cent  greater,  the  temperature  28.92  degrees 
lower,  the  rain-fall  at  Lansing  2.47  inches  more,  the  absolute  humidity 
much  less,  the  relative  humidity  much  more,  the  day  ozone  slightly  more, 
the  night  ozone  considerably  more  and  the  depth  of  water  in  the  well  at 
Lansing  to  have  been  seven  inches  less. 

Compared  with  the  preceding  quarter,  (July,  August  and  September), 
the  reports  from  regular  observers  show  a marked  increase  of  influenza, 
bronchitis  and  tonsillitis,  and  a marked  decrease  of  dysentery,  diarrhea  and 
inflammation  of  the  bowels  in  the  fourth  quarter  of  1893. 

% 

The  Weather  and  the  Health  in  Michigan , in  the  fourth  quarter  of  1893, 
Compared  with  the  average  for  the  seven  years  1886-1892. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quarter  of 
1893,  with  the  average  for  the  fourth  quarters  in  the  seven  years, 
1886-1892,  shows  that  in  1893,  the  prevailing  direction  of  the  wind  was 
the  same  (southwest),  the  velocity  was  slightly  greater,  the  temperature 
was  nearly  the  same,  the  rain-fall  at  Lansing  was  1.67  inches  more,  the 
absolute,  and  the  relative  humidity  were  more,  the  day  ozone  was  less,  the 
night  ozone  was  more  and  the  depth  of  water  in  the  well  at  Lansing  was  4 
inches  more. 

Compared  with  the  average  in  the  corresponding  quarters  in  the  seven 
years,  1886-1892,  the  reports  from  regular  observers  indicate  that  influenza 
was  more  than  usually  prevalent,  and  that  intermittent  fever,  remittent 
fever,  erysipelas  and  inflammation  of  kidney  were  less  than  usually  prev- 
alent in  the  fourth  quarter  of  1893. 

Respectfully  submitted, 

Henry  B.  Baker, 

Secretary. 


ABSTRACT  OF  PROCEEDINGS 

OF  THE 

[ICHIGAN  STATE  BOARD  OF  HEALTH. 


[208.] 


ANNUAL  MEETING  APRIL  13,  1894. 


REPORTED  BY  THE  SECRETARY  OF  THE  BOARD. 


This  was  the  annual  meeting.  A brief  address  was  made  by  the  Pres- 
lent  of  the  Board,  who  congratulated  the  members  of  the  Board  on  the 
ict  that,  “ During  the  last  year  the  State  Board  of  Health  has  done  much 
Dod  work,  including  that  in  connection  with  quarantine  and  the  preven- 
on  of  the  introduction  into  Michigan  of  dangerous  communicable  dis- 
hes. The  Board  has  entered  upon  a most  important  work— for  the 
retention  and  restriction  of  tuberculosis  in  man,  and  I believe  that  the 
?Sults  will  be  great.  This  Board  has  taken  the  lead  of  other  State 
hards  of  Health  in  declaring  consumption  to  be  ‘ dangerous  to  the  pub- 
c health,’  and  has  recommended  advanced  measures  for  its  restriction, 
.t  this  meeting  committees  are  to  report  upon  two  other  measures  of 
Bstriction  which  it  is  believed  will  prove  to  be  exceedingly  important. 
There  were  present  at  this  meeting:  Hon.  Frank  Wells,  president, 
jansing;  Prof.  Victor  C.  Vaughan,  M.  D.,  Ann  Arbor;  Prof.  Delos  Fall, 
I.  S.,  Albion;  Mason  W.  Gray,  M.  D.,  Pontiac;  Samuel  G.  Milner,  M.  D., 
hand  Bapids,  and  Henry  B.  Baker,  M.  D.,  Secretary. 

The  minutes  of  the  last  quarterly  and  two  special  meetings  were  read, 
tie  auditing  of  bills  and  accounts,  and  other  regular  business  was 
ransacted 

The  Secretary  presented  and  read  portions  of  his  report  of  work  done 
a the  office  during  the  quarter  just  ended,  which  included  the  action 
aken  for  the  restriction  of  412  outbreaks  of  dangerous  communicable  dis- 
ases,  6 outbreaks  being  of  small-pox.  The  412  outbreaks  do  not  include 
ne  hundred  and  eightv-five  localities  which  reported  consumption,  and 

^ \T«  5 3 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


o^Health^  whlch  action  was  taken,  in  each  instance,  by  the  State  Boai 
AprilVand  S6UC°eSsful  Sanitary  Convention  has  been  held,  at  Menomine! 


The  Secretary  said  that,  “ Compared  with  the  average  in  the  correspond 
ing  quarters  in  the  eight  years  1886-1893,  the  reports  from  regula 
observers  indicate  that  intermittent  fever,  remittent  fever,  erysipelas 
diarrhea,  consumption,  pneumonia  and  pleuritis  were  less  than"  usuall 
prevalent,  and  that  no  disease  was  more  than  usually  prevalent  in  tii 
first  quarter  of  1894,” 


CONFERENCE  OF  MICHIGAN  HEALTH  OFFICERS. 


It  was  voted  that  the  State  Board  of  Health  hold  this  year  anothe 
Conference  of  Michigan  Hea  th  Officers,  at  Ann  Arbor,  some  time  in  Jurn 
A committee  of  three,  of  which  Doctor  Vaughan  is  chairman,  was  appoints 
to  make  arrangements  for  that  Conference.  Last  year  a useful  Conferenc 
was  held  with  special  reference  to  cholera.  That  subject  is  still  of  inter 
est,  and  dangerous  immigrants  are  still  coming  into  Michigan.  But  it  i 
proposed  this  year  to  give  special  attention  to  that  disease  which  is  alread' 
here  and  causes  most  deaths — consumption;  and  to  give  the  health  officer 
opportunity  to  study  the  subject  at  the  State  Laboratory  of  Hygiene 
where  the  bacteriological  and  other  facts  relative  to  the  causation  of  thi; 
disease  can  be  so  well  demonstrated. 


It  is  believed  that  every  local  board  of  health  in  Michigan  may  well  pav! 
the  expenses  of  its  health  officer  as  a delegate  to  this  meeting,  because  of! 
the  useful  information  which  he  may  there  gain,  for  the  benefit  of  thel 
people  of  his  jurisdiction. 


TUBERCULOSIS  IN  ANIMALS  AND  IN  MAN. 

The  subject  of  tuberculosis  in  animals  as  a cause  of  tubercular  diseases  in1 
man,  was  presented  by  Dr.  Milner  by  a resolution  at  the  special  meeting  at 
Menominee,  April  6,  directing  the  Secretary  of  this  Board  to  institute  au 
investigation  of  the  cattle  and  milk  in  different  parts  of  this  State,  and  report 
in  what  way  and  to  what  extent  the  health  and  lives  of  the  people  are  endan- 
rf  re5rby  tuberculous  meat  and  milk.  The  resolution  was  then  referred  to 
Dr.  Mason  W.  Gray,  the  committee  on  “ Animals’  Diseases  dangerous  to 
man,  with  request  to  report  at  this  meeting.  Dr.  Gray  reported  that  he 
had  conferred  with  veterinary  surgeons  in  Pontiac  and  Detroit,  had  visited 
the  health  department  in  Detroit  for  conference,  that  a few  months  ago  he. 
had  corresponded  on  this  subject  with  members  of  the  State  Live  Stock 
Commission,  and  he  read  extracts  from  the  letters:  Hon.  J.  J.  Woodman 
had  said,  that  the  presence  of  tuberculosis  in  animals  is  not  being  reported 
to  the  State  Live  Stock  Commission.  Dr.  Barringer  had  expressed  the 
hope  that  this  Board  would  investigate  the  subject  thoroughly.  Dr.  Gray 
believed  that  the  State  Live  Stock  Board  would  cooperate  freely  with  this 
Board  in  an  investigation  of  tuberculosis  in  animals. 

Dr.  Baker  said  he  had  conferred  with  the  State  Veterinarian,  who 
advised  further  and  personal  conference  by  this  Board  with  the  State  Live 
Stock  Commission. . Dr.  Baker  read  from  the  last  report  of  the  commis- 
sion, relative  to  tuberculosis  “ It  is  beyond  question  both  infectious  and 
contagious,  particularly  in  the  pulmonary  development  or  consumption  of 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1894 


3 


. ie  lungs.”  “Years  of  added  experience  and  careful  observation  lead  us 
» the  conclusion  that  the  annual  losses  among  Michigan  cattle  from 
| iberculosis  are  much  greater  than  from  all  the  other  contagious  diseases 
fecting  our  domestic  animals,  and  that  the  disease  is  steadily  increasing. 
T’e  have  given  the  subject  very  careful  thought  and  consideration,  and 
| ive  as  yet  failed  to  find  a satisfactory  plan  for  its  treatment  or  extermina- 
I on.  It,  as  yet,  is  one  of  the  unsolved  problems,  lying  all  in  front  and 
I ke  some  bridges,  in  our  pathway,  the  day  is  not  far  distant  when  an 
! tempt  must  be  jnade  to  cross.” 

1 Secretary  Baker  thought  that  now,  since . the  vigorous  action  by  this 
oard  for  the  restriction  of  tuberculosis  in  man,  is  the  favorable  time  for 
Lie  commission  to  make  the  attempt  to  “cross  the  bridge,”  and  he  earnestly 
; ;>ped  that  the  State  Live  Stock  Commission  would  cooperate  with  this 
i oard  in  the  effort  for  the  restriction  and  prevention  of  tuberculosis  in 
liinals  and  in  man. 

It  was  voted  that  the  President  be  requested  to  call  a special  meeting  of 
i iis  State  Board  of  Health  at  such  time  as  arrangements  can  be  made,  for 
joint  meeting  with  the  State  Live  Stock  Commission,  to  consider  the  sub- 
ct  of  the  restriction  of  tuberculosis  in  animals  and  in  man. 

L 

A proposed  State  Hospital  for  Consumptives. 

[At  the  special  meeting  of  this  Board  at  Menominee,  April  6,  1894,  the 
! Beretary  presented  the  subject  of  a proposed  State  Hospital  for  Con- 
imptives.  He  stated  that  since  the  publication  of  the  two  hektographed 
iges  which  he  had  sent  to  each  member  of  this  Board,  and  to  newspapers 
id  journals,  the  proposition  had  been  favorably  received,  the  President 
! this  Board  and  Prof.  Yaughan  had  both  expressed  themselves  as  favor- 
i g the  proposition.  But  the  Secretary  wished  for  such  formal  expression 
: would  make  it  the  Board’s  proposition.  He  moved  the  adoption  of  a 
solution, — “That  the  proposition  for  the  establishment  of  a State  Hospi- 
1 for  Consumptives  is  very  cordially  approved  by  the  State  Board  of 
, ealth.”  The  subject  was  then  discussed.  On  motion  the  resolution  was 
ferred  to  the  standing  committee  on  “Epidemic,  Endemic  and  Communi- 

Ible  Diseases” — Prof.  Victor  C.  Vaughan,  with  request  for  a report  on  it 
the  next  meeting  of  this  Board.  ] 

As  chairman  of  the  Standing  Committee  on  “Epidemic,  Endemic  and 
Dmmunicable  Diseases,”  Prof.  Vaughan  made  a report  on  the  subject  of 
e restriction  of  tuberculosis  in  man  by  means  of  a proposed  State  Hos- 
tal  for  Consumptives,  this  subject  having  been  referred  to  him  at  the 
st  special  meeting.  The  subject  was  discussed  at  great  length  and  reso- 
tions  were  adopted  as  follows: 

Resolved , That  we  recognize  the  following  facts: 

1.  That  tuberculosis  is  the  most  grave  and  fatal  disease  now  affecting  the 
^alth  and  lives  of  the  people  of  this  State,  destroying  about  three  thou- 
nd  lives  per  year; 

i 2.  That  this  disease  originates  principally  by  transmission  from  man  to 
an  or  from  man  to  animals  and  again  to  man; 

, 3.  That  the  spread  of  this  disease  can  be  best  arrested  by  the  disin- 
! ction  of  the  sputa  and  other  discharges,  by  special  supervision  of  those 
fected,  and  by  the  care  of  such  persons  under  conditions  which  will 
event  the  transmission  of  the  disease  to  others; 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


4.  That  such  disinfection  and  supervision  can  not  be  carried  out  in 
the  crowded  houses  of  the  poorer  classes;  and 

5.  That,  under  conditions  which  will  prevent  reinfection,  many  con- 
sumptives may  be  permanently  cured,  and  returned  to  their  homes  and 
work,  educated  in  the  methods  of  restricting  the  disease.  In  view  of  these 
facts  * 

Resolved , That  this  Board  request  of  the  next  Legislature  an  appropri- 
ation of  $ , for  the  purpose  of  building,  equipping  and  maintain- 

ing a State  Hospital  for  Consumptives. 

Prof.  Delos  Fall  presented  a preamble  and  resolution,  which  were 

adopted  as  follows : . 

Whereas,  It  is  desirable  that  every  step  taken  shall  tend  toward  giving 
the  largest  amount  of  sanitary  education  to  the  teachers  and  to  the  peo- 
ple of  the  State,  therefore, 

Resolved,  That  it  is  the  judgment  of  this  Board  that  the  proposed  State 
Hospital  for  Consumptives  should  be  located  at  the  seat  of  the  State 
University  at  Ann  Arbor,  in  order  that  it  may  afford  the  best  opportuni- 
ties for  the  observation  and  study  of  this  most  important  disease,  in  con- 
junction with  the  investigations  now  being  so  satisfactorily  pursued,  in 
bacteriology  and  other  departments  of  sanitary  science,  at  the  State  Lab- 
oratory of  Hygiene.  ' 

Sputa  may  be  Examined  at  the  State  Laboratory  of  Hygiene . 

For  the  convenience  of  physicians  in  the  diagnosis  of  a case  of  tuber- 
culosis, it  was  suggested  that  there  should  be  some  central  place  where  the 
sputa  of  persons  suspected  to  be  suffering  with  tuberculosis  could  be  bac- 
teriologically  examined,  at  a slight  cost  to  the  physician  or  patient.  Reply- 
ing to  an  inquiry  whether  the  State  Laboratory  of  Hygiene  would  make 
these  examinations,  Dr.  Vaughan  said  that  he  would  have  such  examinations 
made  there  at  a small  cost  to  the  physician  or  patient.  Any  physician 
wishing  such  examination  made  at  the  State  Laboratory  of  Hygiene 
should  correspond  with  Prof.  Victor  C.  Vaughan,  M.  D.,  Director  of  the 
State  Laboratory  of  Hygiene,  .Ann  Arbor,  Michigan. 

IS  THE  USE  OF  ATROPINE  IN  FITTING  GLASSES  A BRANCH  OF  THE  PRACTICEj 

OF  MEDICINE. 

The  Secretary  mentioned  that  he  had  received  letters,  asking  whether  oi 
not  atropine  could  legally  be  used  in  fitting  glasses  in  cases  where  the 
optician  was  not  a Doctor  of  Medicine,  and  whether  or  not  such  an 
optician  would  be  required  to  comply  with  the  State  law  relative  to  the 
practice  of  medicine.  Recently  the  Secretary  had  received  an  interesting 
letter  on  this  subject  from  a prominent  physician  in  Michigan,  which  he 
read  to  the  members  of  the  Board.  The  letter  is  as  follows: 

Grand  Rapids , Michigan , February  21,  1894. 

H.  B.  Baker , M.  D.,  Secretary  State  Board  of  Health,  Lansing,  Michigan. 

My  dear  Doctor There  is  a law  in  the  State  of  Michigan  to  regulate  the  practice  of  medicine  (“  Tc 
promote  the  public  health”).  Under  said  law,  a man  is  required  to  register,  etc.,  before  practicing  med- 
icine in  any  branch,  or  prescribing,  etc.  In  these  days  the  practice  of  medicine  includes  all  specialties 
and  any  specialty  or  part  thereof  is  the  practice  of  medicine,  in  the  meaning  of  the  law.  Now,  is  nol 
the  use  of  atropine  in  the  eyes  in  fitting  glasses  a prescription  or  prescribing  for  a patient  in  the  same 
sense  that  making  a plate  and  extracting  the  teeth  preparatory  thereto,  is  practicing  dentistry?  If  per 


ABSTRACT  OP  PROCEEDINGS,  APRIL  13,  1894. 


5 


sons  should  have  trouble  with  their  eyes,  and  think  they  needed  glasses  and  go  to  an  advertising  optician 
{spectacle  vender)  and  he  was  in  the  habit  of  using  atropine  in  eyes,  now  suppose  this  said  patient  had 
acute  or  chronic  glaucoma,  the  optician  would  not  know  it,  having  no  knowledge  of  opthalmology,  and 
he  would  put  atropine  into  the  patient’s  eyes,  it  might  be  the  cause  of  the  patient  losing  the  sight  of  both 
eyes.  You  see  the  point.  The  use  of  atropine  or  any  midriatic  in  glaucoma  does  harm,  and  frequently 
causes  blindness,  therefore  the  necessity  of  great  care  in  selecting  cases  in  which  there  are  eye  symptoms 
in  which  atropine  is  a safe  remedy.  The  case  in  point  is  a spectacle  vender  here  who  fits  glasses,  and 
uses  atropine  in  eyes  for  fitting.  Is  this  not  practicing  medicine,  and  should  men  uneducated  (in  med- 
icine) be  allowed  to  tinker  with  eyes,  when  they  are  the  most  delicate  organs  of  the  body,  and  in  the  face 
of  the  fact  that  so  many  people  lose  their  eyesight  by  neglect  and  improper  treatment?  I have  a patient 
whose  eyes  were  undoubtedly  affected  with  glaucoma;  they  pained  her  and  she  wanted  to  have  glasses 
fitted  by  an  optician;  he  used  atropine  in  her  eyes  which  increased  her  pain  and  she  finally  left  him  and 
went  to  another  optician  who  completed  the  test,  but  she  had  pain  and  symptoms  of  glaucoma  for  a long 
time,  and  her  sight  is  very  much  impaired,  so  glasses  will  not  help  her;  had  she  gone  to  an  oculist  he 
would  have  detected  the  glaucoma  and  given  her  proper  treatment  and  saved  her  eyes.  This  is  a matter 
of  great  importance,  and.  I should  like  your  opinion.  I believe  opticians  have  no  right  to  fit  glasses 
inasmuch  as  the  majority  of  the  young  people  who  need  glasses  should  have  them  fitted  by  a competent 
oculist.  If  people  want  to  call  for  glasses  all  right,  but  opticians  have  no  right  to  advertise  to  fit  them 
any  more  than  a druggist  has  to  advertise  to  prescribe  for  all  the  ills  of  man  (free  of  charge)  to  get  cus- 
; tomers  when  he  is  not  a Doctor.  Please  let  me  hear  from  you. 

Very  truly  yours, 

D.  M.  Greene. 

The  members  of  the  State  Board  of  Health  thought  that  a person  using 
atropine  in  the  eyes  for  the  purpose  of  fitting  glasses  was  practicing  med- 
icine, and  should  comply  with  the  State  law  relative  to  the  practice  of 
medicine. 

CONSUMPTION  A DISEASE  DANGEROUS  TO  THE  PUBLIC  HEALTH. 

A special  report  by  the  Secretary. 

So  far  as  known  at  this  office,  the  Michigan  State  Board  of  Health  was 
the  first  State  Board  to  take  action  for  the  notification  of  this  most  import- 
1 ant  cause  of  deaths.  Sept.  30, 1893,  this  Board  officially  declared  consump- 
tion and  other  diseases  due  to  the  Bacillus  tuberculosis  to  be  “ diseases 
dangerous  to  the  public  health”  and,  in  accordance  with  Sections  1675  and 
1676  Howell’s  Statutes,  to  be  reported  by  householders  and  physicians  to 
the  local  health  officer,  as  soon  as  such  a disease  is  recognized.  This 
recent  action  was  for  the  legal  control.  This  Board  has  carried  on  an 
educational  campaign  since  the  year  1881,  wThen  it  first  published  and 
distributed  information  relative  to  the  contagious  character  and  prevention 
of  consumption.  Since  that  time  much  has  been  written,  published  and 
distributed  on  this  subject  by  this  Beard.  In  Sept.,  1891,  the  Board  pub- 
lished a four-page  leaflet  on  “ The  Restriction  and  Prevention  of  Con- 
i sumption,”  to  the  number  of  5,000  copies.  One  other  edition  of  five 
thousand  copies  of  the  pamphlet  has  been  printed.  It  is  believed  that  the 
pamphlet  has  been  instrumental  in  the  education  of  the  people  for  the 
restriction  of  tubercular  diseases. 

Action  by  the  New  York  City  Board  of  Health. 

According  to  the  Sanitarian  of  March,  1894,  the  New  York  City  Board 
of  Health,  on  July  13,  1893,  took  action  for  the  restriction  and  prevention 
of  tuberculosis.  The  Report  of  JDr.  Cyrus  Edson,  Chairman  of  the 
Sanitary  Committee  of  the  City  Board  of  Health,  was  adopted.  It 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


summarized  a report  which  Dr.  Herman  M.  Biggs,  the  bacteriologist  of 
the  Department,  had  made,  and  which  was,  in  the  opinion  of  Dr.  Edson, 
timely  and  well  advised.  Dr.  Biggs’  report  is  summed  up  in  the  following 
three  statements:  First , tuberculosis  is  a contagious  disease,  and  is  dis- 
tinctly preventable;  Second , it  is  acquired  by  direct  transmission  of  the 
tubercle  bacilli  from  the  sick  to  the  well,  usually  by  the  means  of  the  dried 
and  pulverized  sputum  floating  in  the  dust  of  the  air;  and  Third , it  can 
be  largely  prevented  by  simple  and  easily  applied  measures  of  cleanliness 
and  disinfection. 

Dr.  Edson’s  report,  which  was  adopted,  included  recommendations:  1, 
that  an  instructive  circular  be  prepared  and  distributed;  2,  that  physicians 
and  other  persons  having  knowledge  of  the  existence  of  a case,  report  it 
to  the  Health  Department  within  seven  days;  3,  that  the  medical  sanitary 
inspectors  should  investigate  the  cases  and  get  samples  of  the  sputa  for 
diagnostic  purposes,  as  is  done  in  diphtheria,  and  if  tubercle  bacilli  are 
found  the  inspector  is  to  inform  the  physician  and  request  him  to  instruct 
the  patient  and  persons  liable  to  be  endangered,  or  if  the  physician  pre- 
fers the  inspector  gives  these  notices;  4,  that  the  Board  urge  upon  hos- 
pital authorities  of  the  city  of  New  York  the  importance  of  separation  so 
far  as  possible  in  the  hospitals  in  this  city  of  persons  suffering  from  pul- 
monary tuberculosis  from  those  affected  with  other  diseases,  and  urge 
that  proper  wards  be  set  apart  for  the  exclusive  treatment  of  this  disease, 
and  that  the  commissioners  of  Charities  and  Corrections  be  recommended 
to  take  such  steps  as  will  enable  them  to  have  and  control  a hospital  to  be 
known  as  the  “Consumptive  Hospital”  to  be  used  for  the  exclusive  treat- 
ment of  this  disease,  and  that  as  far  as  practicable,  all  inmates  of  tho 
institutions  under  their  care  suffering  from  tuberculosis  be  transferred  to 
this  hospital;  5,  that  it  be  recommended  that  the  disinfecting  corps  disinfect 
places  where  evidence  of  infection  from  tuberculosis  exists  whenever,  in 
the  opinion  of  the  chief  inspector  of  contagious  diseases,  it  shall  be 
necessary;  and  6,  that  suitable  receptacles  (cuspidors)  be  provided  and 
properly  cared  for  in  all  places  where  persons  are  brought  or  caused  to 
congregate  for  any  purpose,  especially  in  factories. 

According  to  “ The  Doctor  of  Hygiene  ” for  Dec.  20,  1893,  the  New 
York  City  Board  of  Health  has  adopted  the  following  resolutions: 

“ Resolved,  That  this  Board  urge  upon  hospital  authorities  of  the  City  of  New  York  the  importance  of 
separation,  so  far  as  possible,  in  the  hospitals  of  this  City,  of  persons  suffering  from  pulmonary  tuber- 
culosis from  those  affected  with  other  diseases,  and  urge  that  proper  wards  be  set  apart  for  the  exclusive 
treatment  of  this  disease ; and,  be  it  further 

“ Resolved , That  the  Commissioners  of  Charities  and  Corrections  be  recommended  to  take  such  steps 
as  will  enable  them  to  have  and  control  a hospital  to  be  known  as  “The  Consumptive  Hospital,”  to  be 
used  for  the  exclusive  use  of  this  disease,  and  that,  as  far  as  practicable,  all  inmates  of  the  institution 
under  their  care  suffering  from  tuberculosis  be  transferred  to  this  hospital.” 

Action  by  the  New  York  State  Board  of  Health. 

At  a meeting  of  the  New  York  State  Board  of  Health,  February,  1894,. 
Doctor  Edson,  to  whom  the  subject  had  been  referred,  made  a report  stating 
that  “ Tuberculosis  is  a contagious  disease,  and  is  distinctly  preventable;” 
that  it  is  acquired  by  direct  transmission,  usually  by  the  dried  and  pulver- 
ized sputum  floating  as  dust  in  the  air;  and  that  it  can,  to  a great  extent,  be 
prevented  by  cleanliness  and  disinfection.  Dr.  Edson  recommended  that 
instructive  circulars  be  distributed;  that  cases  be  reported  to  the  local 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1894. 


7 


health  officers  within  seven  days  of  the  time  when  the  sick  persons  come 
under  observation,  and  the  health  officers  should  then  take  the  necessary 
action,  visiting  the  premises,  leaving  printed  instructions.  After  the  death 
of  the  patient  the  room  occupied  and  the  premises  should  be  disinfected; 
and  that  cuspidors  be  put  in  all  public  places,  such  as  railroad  cars,  factories, 
stations,  etc.  Dr.  Edson  also  recommended  that  a circular  to  health 
officers  be  sent  out  stating  that  local  health  officers  will  register  the  name, 
address,  sex,  age  of  each  person  suffering  from  tuberculosis ; upon  notice  of 
a case,  inspectors  will  visit  the  premises  and  family  and  leave  instructive 
circulars  relative  to  the  precautions  to  be  taken;  the  thorough  disinfection 
of  all  infected  articles;  and  that  the  authorities  of  all  public  institutions 
that  are  under  the  jurisdiction  of  the  State  Board  of  Health,  such  as  hos- 
pitals, asylums,  prisons,  etc.,  shall  be  required  to  furnish  the  State  Board 
of  Health  the  name  and  last  address  of  every  consumptive  coming  under 
observation  within  seven  days. 

The  recommendations  of  Dr.  Edson  were  embodied  in  a circular  which 
has  been  issued  and  distributed  by  the  Board.  The  disease  was  recognized 
as  a dangerous  communicable  disease,  and  measures  were  recommended 
for  its  prevention  and  restriction.  The  circular  requests  that  physicians 
report  each  case  to  the  health  official  of  the  jurisdiction  in  which  a case 
occurs. 

The  New  York  State  Board  of  Health  has  also  investigated  the  preva- 
lence of  tuberculosis  in  cattle,  and  has  issued  a circular  of  rules  and  regu- 
lations for  inspectors,  owners  or  keepers,  and  all  other  persons  having 
charge  of  cattle  suffering  from  tuberculosis.  Dr.  Balch,  the  secretary  of 
the  board,  writes  “ I have  to  inform  you  that  this  department  has  had  in 
its  employ  two  or  more  competent  veterinarians  to  examine  cattle  supposed 
to  be  tuberculous,  and  have  examined  some  20,000  head  either  by  physical 
or  tuberculin  test.  Of  the  number  examined  some  3 per  cent  were  found 
to  be  tuberculous,  and  were  ordered  killed.  The  work,  however,  had  been 
summarily  stopped  by  order  of  the  board.” 

Action  by  the  Philadelphia  Board  of  Health. 

The  Sanitary  Committee  of  the  Philadelphia  Board  of  Health,  to  whom 
was  referred  the  subject  of  the  restriction  of  tuberculosis,  made  an  elabor-  ' 
ate  report,  and  recommended  a series  of  resolutions,  which  were  adopted 
by  the  board.  The  resolutions  embrace  recommendations  that  registration 
be  postponed  for  the  present;  that  circulars  containing  rules  for  the  pre- 
vention of  the  disease  be  distributed;  that  physicians  be  requested  to 
cooperate  with  the  board  in  the  distribution  of  these  circulars,  and  to 
notify  the  board  of  cases  in  which  disinfection  is  required;  that  a medical 
inspector  visit  each  house  in  which  a death  from  tuberculosis  has  occurred, 
and  satisfy  himself  that  the  premises  have  been  disinfected;  and  that  all 
cases  of  tuberculosis  reported  to  the  Health  Bureau  be  recorded  as  are 
cases  of  other  contagious  diseases. 

The  action  of  the  Philadelphia  Board  is  in  accordance  with  the  recom- 
mendations of  the  County  Medical  Society,  and  in  part  with  the  recom- 
mendations of  the  College  of  Physicians  and  Surgeons. 

Action  by  the  Wayne  County  Medical  Society. 

On  invitation  of  the  Wayne  County  Medical  Society,  the  Secretary  of 
this  Board  read  a paper  before  the  meeting  of  that  society  in  Detroit,  Feb. 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


15,  on  the  subject  of  “ Consumption  as  a Disease  Dangerous  to  the  Public 
Health.”  The  following  resolution  was  adopted  by  the  society: 

“ Resolved , That  hereafter,  consumption  (and  other  diseases  due  to  the  Bacillus  tuberculosis)  shall  be 
included  in  the  list  of  diseases  of  which  notice  should  be  given  by  householders  and  physicians  to  the 
local  health  boards,  as  soon  as  such  a disease  is  recognized.” 

Proposed  Action  by  the  Detroit  Board  of  Health. 

The  Health  Commissioner  and  one  member  of  the  Detroit  Board  of 
Health  were  in  attendance  at  this  meeting  of  the  Wayne  County  Medical 
Society,  and  thought  that  consumption  should  be  reported  to  the  local 
board,  the  subject  of  unsanitary  surroundings,  damp  basements,  etc.,  could 
then  be  investigated,  as  well  as  such  action  as  is  practicable  for  the  restrict- 
ion of  the  disease.  The  Health  Commissioner  thought  it  would  be  practi- 
cable for  the  local  board  to  make  bacteriological  examinations  of  sputa  of 
suspected  cases,  as  soon  as  the  new  health  department  building  is  ready 
for  occupancy. 

Addresses , Discussions,  etc.,  in  Michigan. 

On  invitation  from  the  President  of  the  Michigan  Agricultural  College, 
your  Secretary  read  a paper  in  the  College  Chapel,  Friday  evening,  March 
23,  before  the  faculty  and  students,  on  the  subject:  “ Our  Greatest  Danger, 
and  How  it  may  be  Avoided  ” — “ The  Bacillus  tuberculosis .”  The  Secre- 
tary has  also  read  a similar  paper  before  the  U.  and  I.  Literary  Club  of 
Lansing.  As  is  well  known  to  the  members  of  this  Board  the  subject  of 
the  restriction  and  prevention  of  consumption  was  discussed  at  length,  and 
several  papers  were  read  at  the  recent  Sanitary  Convention  under  the 
auspices  of  this  Board  at  Menominee. 

Action  by  the  Board  of  Health  of  Asbury  Park,  N.  J. 

The  Board  of  Health  of  Asbury  Park,  N.  J.,  has  declared  consumption 
a communicable  disease  dangerous  to  the  public  health,  and  requires  cases 
to  be  reported  to  the  board  of  Health,  where  a record  will  be  made,  circu- 
lars of  information  will  be  issued,  and  measures  will  be  taken  for  the 
restriction  of  the  disease. 

Action  by  the  Ohio  State  Board  of  Health. 

The  Secretary  of  the  Ohio  State  Board  of  Health  has  sent  out  a circular 
letter,  with  schedule  of  seven  questions,  asking  the  physicians  in  Ohio  to 
give  their  views  of  the  practicability  of  the  State  Board  o’f  Health  taking 
action  for  the  prevention  and  restriction  of  consumption. 

The  Subject  Discussed  in  Florida. 

In  a letter  dated  March  24,  Dr.  J.  L.  Horsey,  Assistant  State  Health 
Officer  of  Florida,  informs  the  Secretary  of  the  Michigan  Board  that  he 
had  used  extracts  from  Dr.  Baker’s  paper  read  February  15,  before  the 
Wayne  County  Medical  Society,  and  read  a paper  on  the  subject  of  the 
Restriction  of  Consumption  before  the  Florida  State  Medical  Society,  at 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1894. 


9 


Tampa,  March  20  and  21,  1894,  and  by  so  doing  brought  out  considerable 
discussion,  which  showed  the  views  of  the  medical  profession  of  Florida 
on  this  subject. 

Proposed  Action  in  California. 

The  Scientific  American,  of  March  24,  contains  an  article,  quoted  from 
the  Southern  California  Practitioner,  in  which  it  is  recommended  that 
California  follow  the  example  of  Michigan,  and  officially  declare  Con- 
sumption a Contagious  disease,  and  go  one  step  further  and  deny  con- 
sumptives the  privilege  of  engaging  in  occupations  whereby  they  may 
endanger  the  life  or  health  of  others. 

The  Subject  Discussed  in  Minnesota. 

The  Secretary  has  recently  received  from  H.  Longstreet  Taylor,  A.  M., 
M.  D.,  of  St.  Paul,  Minn.,  a copy  of  his  paper  on  “The  Necessity  of 
Special  Institutions  for  the  Consumptive  Poor.  The  first  step  toward  a 
complete  eradication  of  Tuberculosis,”  in  which  Doctor  Taylor  in  a note 
at  the  end  of  his  paper  says,  “ Since  writing  the  above  the  State  of  Mich- 
igan has,  through  its  efficient  Board  of  Health,  put  tuberculosis  upon  the 
list  of  contagious  diseases  that  must  be  reported  by  the  Physician  to  the 
health  board.  This  will  soon  collect  a mass  of  data  of  the  greatest  value 
to  the  student  of  the  disease  in  that  State,  and  will,  by  the  limitation  of 
the  ravages  of  the  disease  in, Michigan,  soon  force  the  matter  to  the  atten- 
tion of  the  other  States,  and  eventually  the  National  Government  must 
take  it  up.” 

The  movement  for  the  restriction  of  consumption  seems  to  be  a general 
one,  and  other  boards  of  health  will  probably  soon  take  action.  The  fore- 
going brief  statement  has  been  prepared  to  show,  as  far  as  the  Secretary 
is  officially  informed,  what  has  recently  been  done  for  the  restriction  of 
the  most  important  disease — Consumption. 

SECRETARY’S  REPORT  OF  WORK  DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD  OF 
HEALTH,  DURING  THE  QUARTER  ENDING  MARCH  31,  1894. 

Communicable  Diseases. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  dis- 
eases in  Michigan,  received  from  all  sources  and  filed,  Rnd  the  corre- 
sponding number  concerning  which  action  was  taken  by  this  office,  during 
the  quarter,  are  as  follows:  for  diphtheria,  110;  for  scarlet  fever,  184;  for 
typhoid  and  typho  malarial  fever,  55;  for  measles,  57;  for  small-pox,  6. 
Total  for  the  five  diseases,  412.  Consumption  is  mentioned  further  on. 

The  number  of  communications  relative  to  dangerous  communicable 
diseases,  received  and  placed  on  file  during  the  quarter,  was  1,820. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and 
demands  for  weekly  and  final  reports,  on  cards,  or  in  the  form  of  the  cir- 
cular letter,  were  sent  out  during  the  quarter  to  the  number  of  1,662. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  quarter, 
were:  for  diphtheria,  81;  scarlet  fever,  134;  typhoid  and  typho-malarial 
fever,  52;  measles,  18;  small-pox,  3.  Total  for  the  six  diseases,  288. 

During  the  quarter,  the  local  columns  of  newspapers  to  the  number  of 


^ MICHIGAN  STATE  BOARD  OF  HEALTH. 

1,018,  have  been  looked  over  for  reports  of  occurrence  of  communicab] 
diseases.  I his  has  resulted  in  giving  this  office  information  of  the  allege 
occurrence  of  4 outbreaks  of  diphtheria,  11  outbreaks  of  scarlet  fever, 
outbreaks  of  typhoid  and  typho-malarial  fever,  and  2 outbreaks  of  measles 
lo  what  extent  the  reports  of  these  alleged  outbreaks  were  verified  i 
shown  in  the  accompanying  table: 


TABLE  1 --Showing  the  number  of  Outbreaks  of  Diphtheria,  Scarlet  fever,  Typhoi 
fever  and  Measles,  from  Jan.  1 to  March  31, 1894,  of  which  notice  was  received  at  tl 
office  of  the  Michigan  State  Board  of  Health;  the  per  cent  of  reports,  informativ 
concerning  which  was  received  through  the  Newspapers ; the  per  cent  of  newspape 
reports  which  were  confirmed  by  the  health  officer ; the  per  cent  of  newspaper  report 
which  were  denied  by  the  health  officer;  and  the  per  cent  relative  to  which  n 
reply  was  received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources, 
Jan.  1 to 
March  31, 1894. 

Per  cent  of 
all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent  of 
newspaper  re- 
ports which 
were  con- 
firmed by  the 
health  officer. 

Per  cent  of 
newspaper  re- 
ports which 
were  denied  by 
the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports to  whici 
the  health 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria.... 

110 

4 

25 

25 

50 

Scarlet  fever 

184 

6 

55 

0 

45  ! 

Typhoid  fever ... 

55 

5 

33 

33 

33 

Measles 

43 

4 

0 

0 

100 

Averages  for  the  four  diseases 

5 

40 

10 

50 

Consumption  in  Michigan  During  First  Quarter  of  1894. 


Daring  the  quarter  Consumption  was  reported  present  in  185  localities 
in  the  State.  A record  is  kept  of  the  names  of  the  localities,  the  date  of 
the  receipt  of  the  information  that  the  disease  was  present  in  the  locality, 
and  when  correspondence  was  opened  with  the  health  officers  of  the  juris- 
dictions in  which  the  cases  are.  Over  eighteen  hundred  copies  of  the 
four-page  leaflet  on  the  restriction  and  prevention  of  consumption  were 
sent  to  the  different  localities  for  distribution  where  they  would  be  most 
likely  to  do  good. 


Small-pox  in  Michigan. 


There  had  been  no  small-pox  m Michigan  since  January,  1893  (when 
there  was  an  outbreak  at  Springport,  Jackson  Co.,  and  Pittsfield  Tp., 
Washtenaw),  until  the  disease  appeared  during  the  first  part  of  this  quar- 
ter. Small-pox  has  been  reported:  At  Otsego  township  and  Otsego  vil- 

of  Crystal  Palls,  Iron  Co.;  and  in  the  cities 
of  Menominee,  Ishpeming  and  Kalamazoo.  The  total  number  of  cases 
reported  from  the  six  localities  was  16;  the  number  of  deaths  was  4.  A 
statement  of  the  outbreaks  is  as  follows: 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1894. 
Small-pox  in  Allegan  County. 


11 


( 

I In  compiling,  the  outbreak  of  small-pox  in  Otsego  township  would  be 
i eated  as  one  outbreak,  and  the  cases  in  Otsego  village  would  be  treated 
j)  a separate  outbreak;  but  on  account  of  the  intimate  relation  between 
I ie  cases,  the  fact  that  the  cases  all  originated  directly  or  indirectly  from 
l6  first  case,  and  for  convenience  in  this  quarterly  report,  I will  here 
eat  these  cases  as  belonging  to  one  outbreak.  Although  diligent  efforts 
ive  been  made,  the  source  of  the  outbreak  is  in  doubt. 

Theirs/  person  taken  sick  who  is  known  to  have  had  small-pox  was 
'r.  Burnside,  who  resided  just  outside  the  village  in  the  township  of 
tsego,  and  was  taken  sick  Jan.  16.  He  was  employed  in  the  Bardeen 
aper  Company’s  mill,  where  his  work  necessitated  his  handling  baled 
igs.  No  evidence  could  be  obtained  that  he  handled  infected  rags,  unless 
s sickness  from  small-pox  be  considered  such  evidence.  His  wife,  who 
as  employed  in  the  rag  room  in  the  paper  mill,  was  slightly  indisposed  a 
w days  prior  to  Mr.  Burnside’s  illness,  but  it  cannot  be  ascertained  with 
‘rtainty  that  she  had  varioloid.  Mr.  Burnside’s  illness,  when  he  was  first 
.ken  sick,  was  diagnosed  as  scarlet  fever.  Burnside  was  taken  ill  with 
ipposed  scarlet  fever  January  9,  and  died  on  the  morning  of  January  16. 
The  second  case  (varioloid)  in  this  outbreak  was  Dr.  Milton  Chase,  the 
llage  health  officer,  who  was  called  to  treat  Mr.  Burnside.  Doctor  Chase 
is  recovered.  The  third  case  was  a Mr.  Bopp  who  resided  in  the  village 
id  had  been  nursing  the  first  case.  Th q fourth  and  fifth  cases  were  two 
derly  people,  Mr.  and  Mrs.  Sherwood,  residing  in  the  village  of  Otsego, 
id  at  whose  house  Mr.  Ropp  boarded.  Mr.  Sherwood  died.  The  sixth 
as  a Mrs.  Herrington,  who  kept  a boarding  house  just  outside  the  village 
mits.  The  source  of  contagium  in  this  case  was  supposed  to  be  the 
btending  physician  who  had  attended  the  other  patients,  and  had  been 
eating  Mrs.  Herrington  for  some  other  ailment.  Mrs.  Herrington 
^covered.  March  13,  a final  report  was  received  from  the  township,  and 
ie  from  the  village.  No  other  cases  are  expected  to  occur. 

January  30,  the  Secretary  of  this  Board  received  a telegram  from  E.  J. 
ose,  Clerk  of  the  Otsego  Board  of  Health  saying  “ Disagreement  as  to 
hether  we  have  small-pox  in  Otsego  or  not.  Come  at  once.  Answer.” 
a accordance  to  the  foregoing  request  for  an  expert,  Dr.  J.  J.  Mulheron,  *• 
it  Detroit,  was  requested  to  go  to  Otsego,  which  he  did,  and  the  following 
his  report: 

Small-Pox  in  Otsego , Allegan  County , Michigan. 

“ Detroit , February  2 , 1894. 

Henry  B.  Baker,  M.  D.,  Secretary  State  Board  of  Health,  Lansing,  Michigan: 

1 Dear  Doctor:— Pursuant  to  instructions  received  from  you  to  proceed  to  Otsego,  Allegan  County, 
investigate  the  alleged  outbreak  of  small-pox  at  that  place,  I left  Detroit  by  M.  C.  E.  R.  on  the  after- 
>on  of  January  31.  An  accident  to  the  engine  of  the  train  at  Parma  caused  a delay  which  necessitated 
,7  remaining  at  Kalamazoo  over  night.  I reached  Otsego  at  7:30  A.  M.  of  the  1st  inst,  and  reported  at 
ce  to  Dr.  F.  W.  French,  the  local  health  officer.  After  receiving  his  statement  as  to  the  status  of  affairs 
vas  driven  to  the  bouse  of  D.  A.  Ropp,  which  I found  placarded  for  small-pox.  After  removing  my 
ercoat  and  donning  an  oil  cloth  ulster  I proceeded  to  make  an  examination  of  Mr.  Ropp,  who  was  con- 
led  to  his  bed.  This  examination  revealed  a case  of  varioloid,  the  eruption  being  in  the  pustular  stage. 
■*ound  the  house  and  its  inmates  carefully  quarantined  as  per  the  regulations  prescribed  by  the  Michigan 
ate  Board  of  Health. 

’*  I next  visited  the  residence  of  Dr.  Milton  Chase,- on  the  porch  of  which  I noticed  two  placards  and  a 
I flag.  One  of  these  placards  bore  the  word  “ small-pox,”  and  the  other,  over  which  floated  the  red 
2 


12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


flag,  indicated  “ chicken-pox.”  I learned  that  the  small-pox  placard  had  been  put  in  place  by  the  1 
health  authorities,  and  that  the  chicken-pox  sign  and  the  red  flag  were  posted  at  the  instance  of 
Chase,  the  occupant  of  the  house.  I entered  unaccompanied  and  was  cordially  met  by  Dr.  Chas< 
whom  I explained  the  object  of  my  visit.  I found  that  the  doctor  himself  was  the  patient  in  regar. 
whose  ailment  there  existed  the  difference  of  opinion  indicated  by  the  two  placards  on  the  hones 
submit  herewith  the  doctor’s  own  typewritten  statement  regarding  his  case. 

‘“On  Tuesday,  January  23,  1894, 1 got  out  of  bed  after  having  had  several  light  chills,  and  si 
general  .pains,  during  the  night.  Through  the  day  I had  several  light  chills,  slight  fever,  and  a g 
deal  of  mental  depression. 

“ ‘ On  the  24th,  symptoms  about  the  same,  but  a little  increased  sense  of  prostration. 

“ 4 On  the  25th,  about  the  same,  except  that  I could  not  sleep  during  the  night,  was  much  depressed, 
thought  best  to  keep  my  bed. 

“ 4 Had  a restless  night  on  the  26th,  but  no  chills,  although  a slight  fever,  and  much  sense  of  prostral 

44  4 On  the  27th  had  a slight  chill,  and  a little  fever  during  the  night,  slept  a little  and  felt  much  bet 
Was  about  the  house  during  the  day.  Had  two  or  three  small  points  of  some  eruption  on  my  fore! 
appear  during  the  day. 

44  4 On  Sunday  28,  feel  better  than  yesterday,  slept  better  during  the  night,  no  chills  or  fever, 
irruptive  points  on  my  forhead  are  one  celled  vessicles. 

44  4 29.  Had  a better  day  than  'yesterday.  Vessicles  fully  developed,  and  new  ones  appearing  on  b 
breast  and  arms. 

44  4 80.  First  vessicles  dried  down,  some  of  the  newer  ones  disappearing,  and  some  new  ones  appeal 
on  left  arm  and  on  head.’ 

“The  doctor  believed  himself  to  be  suffering  from  varicella.  In  this  diagnosis  I did  not  concur 
gave  it  as  my  opinion,  based  on  the  appearance  of  the  eruption  and  the  age  of  the  patient  (about  60  ye 
that  the  disease  was  varioloid.  The  doctor  readily  acquiesced  and  forthwith  ordered  the  chicken-pox  c 
removed. 

'‘'‘History.  During  the  late  Christmas  holidays  Mr.  Abram  Burnside,  aged  42,  and  his  wife,  b 
employes  of  the  Bardeen  Paper  Mills  of  Otsego,  made  a trip  to  Allegan  in  the  same  county  where  t 
spent  one  day.  The  exact  date  of  the  visit  I could  not  ascertain.  Soon  after  their  return  (how  soc 
could  not  ascertain)  Mrs.  Burnside  was  indisposed  for  a few  days  during  which  a slight  eruptioi 
4 pimples  ’ appeared  on  her  body.  The  nature  of  the  eruption  could  not  be  ascertained  as  the  indisp 
tion  was  not  sufficient  to  cause  her  to  call  in  medical  aid.  Shortly  after  Mr.  Burnside  sickened,  ar 
submit  herewith,  the  history  of  the  case  which  was  kindly  furnished  me  by  Dr.  Milton  Chase,  his  med 
attendant: 

“ 4 History  of  the  irregular  case  of  Scarlet  Fever , that  occurred  in  the  village  of  Otsego , Mich .,  during 
month  of  J an.,  1894. 

44  ‘On  the  9th  day  of  Jan.,  1894,  Dr.  M.  Chase  was  called  to  see  one  Abram  Burnside,  who  lives  in 
northwest  part  of  said  village,  having  no  other  resident  member  of  his  household,  save  his  wife. 

44  4 He  was  an  American  born,  Caucasian,  aged  about  42  years,  an  employee  in  the  Paper  Mill  at  Ots 
village.  His  business  was  that  of  a foreman  in  the  rag-room  and  his  duties  consisted  mainly  in  gett 
up  bales  of  rags,  from  the  store-room,  and  opening  them  up,  ready  for  the  assorter’s  use,  and  remov 
them  after  they  had  been  assorted.  He  had  been  in  this  employment  for  more  than  three  years,  last  p< 

44  4 By  history  he  was  found  to  be  a man  of  temperate  habits  and  good  hygienic  and  social  habits, 
wife  was  also  an  employee  in  the  same  mill  with  hjm,  in  the  rag  department.  He  had  had  very  lil 
sickness  during  his  life,  was  about  5 ft.  7 in.  high,  and  weighed  about  175  pounds.  He  was  of  rathe 
muscular  and  sanguine  temperament. 

“ 4 He  had  not  been  away  from  home,  save  a trip,  one  day,  to  Allegan,  during  the  holidays  last  past, 
could  not  recall  that  he  had  seen  any  one  sick  with  any  irruptive  skin  disease.  So  much  for  a prelin 
ary  statement. 

“ 4 1 found  him  suffering  from  fever  of  a moderate  degree,  and  a good  deal  of  general  muscular  ps 
He  complained  most  of  pain  in  his  back  and  head.  Tongue,  not  badly  coated,  moderate  nausea,  and 
vomiting. 

“ 4 On  the  11th,  I was  called  to  see  him  again,  and  I visited  him  one  or  more  times,  each  succeeding  c 
until  the  16th,  on  which  day  he  died. 

“‘On  the  11th,  he  had  very  much  the  same  symptoms  as  at  my  first  visit,  to  which  was  added 
appearance  of  a rash  upon  his  face,  neck,  and  chest,  that  presented  itself  in  thickly  set  spots,  about  > 
an  inch  in  diameter,  that  did  not  feel  rough  or  hard.  He  had  a fine,  evenly  diffused  redness  of  the  ton 
and  fauces.  He  had  acute  inflammation  of  the  tonsils  and  the  papillae  of  the  tongue  were  enlarged  ; 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1894. 


13 


ided  through  its  coating.  He  complained  of  a difficulty  in  swallowing  and  had  very  little  thirst,  or 
) for  food. 

)n  the  12th  he  was  much  the  same  in  general  conditions  as  on  the  11th,  but  the  rash  had  extended 
is  arms  and  trunk,  and  down  onto  his  thighs,  and  on  his  face  and  neck  it  was  blended  into  an  even 
t-colored  rash.  The  rash  did  not  have  the  feel  of  papulae  or  any  sharply  defined  areas.  He  had  con- 
ble  delirium,  but  could  be  controlled  by  the  persuasions  and  advice  of  his  wife.  There  was  also 
tsed  difficulty  in  swallowing.  He  complained  quite  a good  deal  of  general  itching, 
in  the  13th  this  rash  discolored  the  entire  surface  of  his  body,  and  looked  too  dusky  to  be  called  red 
mid  not  be  called  black. 

>n  the  14th,  about  the  same  general  conditions,  only  in  higher  grade,  extreme  restlessness,  and  the 
ilty  in  swollowing  so  great  that  he  could  not,  or  would  not  swallow  anything  save  a little  water. 

Jp  to  this  time,  his  wife  had  had  no  assistance  in  caring  for  him,  but  said  she  could  care  for  him  one 
night. 

t no  time  up  to  this  date  had  the  thermometer  registered  more  than  102°.  His  pulse  was  quite  soft 
ad  a frequency  of  110.  He  breathed  as  if  he  had  some  bronchial  difficulty,  respirations  24  a minute, 
d slept  some  during  the  night  and  day  in  short  naps,  was  still  delirious  but  could  be  controlled  by 
age. 

luring  the  day  sometime,  while  his  wife  was  temporarily  absent  at  an  out  house,  she  found  him, 

her  return,  standing  at  the  pump,  clad  only  in  his  shirt,  pumping  water  on  his  feet. 

)n  the  fifteenth  there  was  a general  appearance  of  great  exhaustion.  He  had  not  been  able  to  take 

f his  medicine,  and  an  extremely  email  amount  of  water.  The  color  of  his  face  was  black,  shading 

" to  a dark  red  on  his  chest  and  scarlet  on  his  legs.  There  was  a little  tendency  to  flakey  desquama- 

)n  his  forehead.  His  respiration  was  more  hurried,  pulse  softer  and  about  110.  He  could  answer  all 

ions  put  to  him  intelligently,  but  was  still  delirious,  when  left  to  himself,  having  short  spells  of 

ness  of  from  5 to  10  minutes  long.  There  were  quite  large  and  flakey  scales  over  his  face,  ears  and 

This  was  at  morning  call.  In  the  evening  the  conditions  were  about  the  same  as  in  the  morning, 

increased  restlessness  and  less  obedience  to  commands.  He  had  been  able  to  swallow  practically 

ng  during  the  day,  and  for  the  first  time  during  his  sickness,  assistance  was  called  in  (a  nurse 

' ired).  [This  was  D.  A.  Eopp,  the  man  to  which  I have  referred  as  suffering  from  varioloid  — J.  J. 

) . 
eron.J 

•jn  the  16th,  at  morning  visit,  about  8 A.  M.,  the  patient  was  found  in  collapse,  and  soon  after  died. 

[ story  of  the  case,  through  the  night,  I learned  that  the  patient  was  found  able  to  swallow,  along 
1 11  or  12  o’clock  at  night.  He  was  extremely  restless  and  irritable  during  the  night.  I was  at  the 
de  at  the  time  of  his  death. 

I There  was  at  no  time  during  the  patient’s  sickness  a vesicle  or  a pustule  on  his  body.  I think  that 
ig  the  last  night  of  his  sickness,  from  the  history  given  by  the  attendant,  and  the  condition  pre- 
id  in  the  morning,  that  he  had  had  a tonsillar  abscess  break  during  the  night. 

[ advised  the  widow  that  there  should  be  a speedy  burial  of  the  corpse,  that  it  should  be  wrapped  in 
infected  sheet,  placed  in  the  coffin,  and  that  the  coffin  should  not  be  afterwards  opened,  and  that 
r,  should  be  no  funeral  services  at  the  house,  and  that  only  a few  of  the  intimate  friends  should  be 
Led  to  follow  it  to  the  grave.  That  at  the  grave  there  should  be  only  a short  ceremony.  To  all  this 
■ widow  agreed,  and  it  was  so  done.  By  her  request,  I went  to  the  undertaker  and  told  him  how 
rad  agreed  to  dispose  of  the  corpse,  and  requested  that  he  use  all  the  antiseptic  precaution  necessary 
revent  the  contagion  going  out  of  the  coffin,  during  the  process  of  burial.  This  he  told  me  he 
d do,  and  afterwards  told  me,  he  did  do.’ 

\ am  clearly  of  the  opinion  that  Abram  Burnside  suffered  and  died  of  small-pox,  of  the  hemorrhagic 
sty,  that  D.  A.  Ropp,  his  nurse,  contracted  a severe  attack  of  varioloid  from  his  exposure  to  the  case, 
that  Dr.  Milton  Chase,  his  attending  physician,  escaped  with  a very  mild  attack  of  varioloid, 
j cannot  close  this  report  of  my  investigation  without  expressing  my  admiration  of  the  intelligent 
! energetic  action  of  the  local  Board  of  Health  in  the  serious  danger  which  threatened  the  residents  of 
1 go  and  the  adjacent  country  * In  the  absence  of  an  efficient  board  of  health  during  the  emergency  the 
ralence  of  small-pox  would  unquestionably  have  been  very  general.  As  it  is  there  is  good  reason  to 
| ive  that  the  trouble  was  stamped  out  in  its  very  incipiency. 

“ Very  respectfully  yours, 

J.  J.  MUIiHERON,  M.  D.” 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 

Small-pox  in  Crystal  Falls,  Iron  county. 

The  second  outbreak  of  small-pox  occurred  in  Crystal  Falls  villas 
Iron  county.  The  first  and  only  case  reported  was  taken  ill  Monday. 
19,  1894.  The  patient  was  a male  school  teacher,  aged  35  years.  Eh 
been  indisposed  the  previous  Friday,  but  taught  school  that  day  an 
following  Monday  until  noon.  Monday  afternoon  he  called  upon  a 
sician,  and  at  a conference  of  the  health  officer  and  the  attending  phys 
on  the  following  morning  it  was  decided  that  the  patient  was  sufi. 
from  small-pox.  Relative  to  the  source  of  contagium  of  this  outbreal 
health  officer,  Dr.  Darling,  writes  March  10,  as  follows: 

“ Regarding  the  case  of  small-pox  in  our  village,  would  state  that  Mr.  Williams,  who  is  the  victi 
a teacher  in  our  public  schools,  and  was  obtained  through  the  S.  R.  Winchell  Teachers’  Agen 
Wabash  ave.,  Chicago.  He  had  been  here  about  a week  when  taken  sick,  and  said  he  did  not  knov 
had  been  exposed.  As  soon  as  I found  he  had  small-pox,  I quarantined  the  house  and  all  the  in 
It  has  now  been  21  days  since  he  ‘ broke  out  ’ and  the  school  board  desires  to  commence  school 
row.  (There  were  no  new  cases  and  the  man  is  getting  well.)  But  I thought  better  to  wait  anothe 
as  I think  the  most  dangerous  time  is  as  desquamation  is  taking  place.  I told  them  I would  wr 
and  get  your  opinion.  Please  answer  by  return  mail  and  oblige. 

“Yours  respectfully, 

“A.  M.  Dabli 

The  following  reply  was  sent  to  Dr.  Darling: 

“ Deab  Sir:— Accept  thanks  for  your  letter  of  March  10,  relative  to  small-pox,  in  your  village 
average  duration  of  the  infectiousness  of  small-pox  after  apparent  complete  recovery,  and  with  el 
disinfection,  is  probably  six  weeks.  So  long  as  a patient,  who  is  recovering  from  the  disease,  sho 
process  of  desquamation,  he  should  be  kept  in  isolation,  and  the  health  officer  should  be  very  su: 
desquamation  has  ceased  before  releasing  him,  and  that  should  not  be  done  until  after  thorough  dii 
tion  of  his  clothing.  Particular  attention  should  be  paid  to  the  disinfection  of  the  patient’s  ha 
beard.  He  should  also  take  a bath. 

As  a rule,  this  Board  does  not  advise  the  closing  of  schools  where  dangerous  communicable  d: 
are  present,  but  does  advise  the  complete  isolation  of  any  person  sick  or  infected  with  such  a d 
Also  the  disinfection  of  any  infected  thing  or  room.” 

The  final  report  of  this  outbreak  at  Crystal  Falls  has  not  yet 
received,  but  it  is  inferred  that  no  new  cases  have  occurred,  that 
patient  has  recovered  and  that  the  outbreak  is  over. 


Small-pox  in  Menominee,  Menominee  county. 

The  third  outbreak  was  reported  by  telegraph  from  Menominee, 
26.  The  source  of  contagium  was  given  as  “ brought  from  Fort  Hov 
Wisconsin..  In  this  outbreak,  to  the  close  of  the  quarter,  there  has  I 
reported  six  cases  and  two  deaths.  No  new  cases  or  deaths  have  1 
reported  since  the  week  ending  March  17.  A notice  from  the  Secretar 
the  Wisconsin  State  Board  of  Health,  dated  Feb.  14,  informed  this  c 
that  four  cases  and  one  death  had  occurred  up  to  that  date,  at  Fort  E 
ard,  Wis.  The  date  of  that  notice  (Feb.  14)  antedates  the  date  of  the 
covery  of  the  first  case  at  Menominee  just  12  days.  No  final  report 
yet  been  received  relative  to  this  outbreak  at  Menominee. 

Small-pox  in  Marquette  County. 

The  fourth  outbreak  of  small-pox  occurred  at  Ishpeming,  March  13, 1 
Relative  to  the  source  of  contagium  in  this  outbreak,  Dr.  Geo.  G.  Bari 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1894. 


15 


tv  health  officer,  writes  March  18.  “ Patient,  with  a partner,  have 

on  a tramp  from  Spring  Yalley,  111.  They  reached  here  last  Tuesday, 
ne  of  them,  a Mr.  Martin  Lucas,  was  taken  sick  the  same  night,  but 
cted  to  call  a physician  until  last  evening.  I immediately  quaran- 
; the  whole  family,  and  this  morning  vaccinated  them  all.  It  is  not  a 
b case,  and  I trust  we  may  be  able  to  keep  it  confined  to  one  house, 
eel  like  congratulating  ourselves  on  the  fact  that  we  have  vaccinated 
people,  mostly  children,  within  the  past  three  weeks,  and  with  most 
lent  success.  It  is  quite  probable  that  he  ^ contracted  the  disease  m 
igo,  but  of  course  we  cannot  say  positively.” 

his  weekly  report  for  the  week  ending  March  24,  the  health  omcer 
ts  one  other  case,  and  says,  “ Small-pox  from  same  source  as  the  first 
nt,  or  from  first  patient.”  From  that  it  may  be  inferred  that  the 
id  case  is  the  “ partner”  spoken  of.  From  other  sources  it  is  learned 
che  two  men  had  left  Ishpeming  some  weeks  previous,  in  search  of 

i,  and  had  gone  to  Spring  Valley,  111.,  and  not  being  successful  there, 

rone  to  the  “ drainage  canal”  near  or  in  Chicago,  and  from  there  had 
ned.  home  to  Ishpeming.  , . 

om  Jan.  1,  1894,  to  Feb.  14,  1894,  there  had  occurred  m Chicago  259 
of  small-pox,  and  it  is  very  probable  that  the  disease  in  this  fourth 
teak  was  contracted  in  Chicago  or  its  suburbs. 

Small-pox  in  Kalamazoo  County. 

ie  fifth  and  last  outbreak  was  reported  at  Kalamazoo  city,  March  28. 
live  to  this  outbreak  Doctor  Adolph  Hochstein,  the  city  health  officer, 
e March  27,  as  follows: 

liter  Jackson,  aged  15,  colored,  returned  from  Chicago  two  weeks  ago  today,  after  staying  there  one 
, Last  Saturday  morning  he  took  sick,  but  a physician  was  not  called  in  until  yesterday  noon.  This 
oon  I was  requested  by  the  attending  physician,  who  regarded  the  case  as  suspicious,  to  see  the 
t with  him,  and  I found  a case  of  confluent  small-pox  in  the  papular  stage,  some  vesicles  had  put 
ir  appearance. 

e patient  is  under,  strict  quarantine  with  two  nurses.  Five  other  individuals,  who  have  been 
; ?d,  are  also  under  quarantine  in  another  house.  Necessary  vaccination  is  being  done, 
little  13  year  old  boy,  who  has  been  exposed,  left  yesterday  morning  for  Grand  Rapids.  I will 
iiately  communicate  the  facts  to  the  health  officer  of  that  city. 

>u  will  oblige  us  here  by  withholding  the  matter  from  the  press.”* 

amediately  upon  the  receipt  of  Dr.  Hochstein’s  letter  at  this  office,  a 
t was  sent  to  the  health  officer  of  the  city  of  Grand  Rapids,  informing 
that  an  infected  person  had  gone  to  his  city  from  Kalamazoo.  Pam- 
ts  on  the  restriction  and  prevention  of  small-pox  were  also  sent, 
rom  the  foregoing  it  may  be  seen  that  small-pox  was  present  at  the 
3 of  the  quarter  in  three  different  localities  in  the  State,  and  probably 

j , but  it  is  fair  to  assume  that  the  outbreak  at  Crystal  Falls  is  over. 

Compiling , Editing , Proof-reading,  Printing,  etc. 

I compilation  of  reports  from  health  officers  and  clerks  has  been  made, 
i compilation  proved,  and  the  article  relative  to  Measles  in  Michigan  in 
I L has  been  commenced;  the  compilation  of  the  reports  relating  to 


' iia  request  was  not  complied  with,  because  it  is  contrary  to  the  settled  policy  of  giving  the  public 
[ [formation,  to  enable  all  to  cooperate  for  the  general  safety. 


16  MICHIGAN  STATE  BOARD  OP  HEALTH. 

Typhoid  Fever  in  Michigan  in  1891  has  been  completed:  the  compilatii 
relating  to  Diphtheria  in  Michigan  in  1891  has  been  completed,  and  b 
work  of  writing  the  article  has  been  commenced;  and  the  compilatii 
relating  to  Scarlet  Fever  in  Michigan  in  1891  has  been  made,  and  t. 
article  is  practically  ready  for  the  printer.  Some  new  and  useful  tabl 
have  been  incorporated  in  the  articles  relative  to  Scarlet  Fever  and  Dip 
theria,  especially  those  showing  the  death-rates  per  10,000  inhabitants 
each  county,  and  in  each  tier  of  counties  in  Michigan. 

The  index  for  the  Annual  Report  for  1891  has  been  completed,  and  tl 
Report  is  now  being  bound,  and  it  is  hoped  to  have  copies  for  distribute 
soon. 

Proof  on  the  “ first  part  ” of  the  Annual  Report  of  the  Secretary  f, 
the  fiscal  year  ending  June  30, 1891,  and  on  the  index  for  the  1891  Repoi 
has  been  read,  and  the  “ first  part  ” of  the  Report  for  1892  is  ready  f< 
the  printer.  The  printing  on  the  last  part  of  the  Annual  Report  of  tl 
Secretary  for  1892  has  been  commenced,  and  proof  has  been  read  on  tl 
articles  “Meteorological  Conditions  in  Michigan  in  1891”  and  “Tl 
Time  of  Greatest  Prevalence  of  Each  Disease  in  Michigan  in  1891.” 

Work  has  been  begun  on  the  articles  relative  to  Meteorology  and  Sic] 
ness  Statistics,  and  on  the  “first  part”  of  the  Annual  Report  for  1893. 

Hektograph  Work,  Correspondence,  etc. 

During  the  quarter  2,400  pages  of  hektograph  work  have  been  made,  < 
which  600  pages  were  relative  to  a paragraph  quoted  from  the  title  page  ( 
the  annual  report  of  the  Australian  Health  Society  for  1892-93,  wkic 
paragraph  had  been  quoted  from  a paper  by  the  Secretary,  and  related  t 
the  Michigan  plan  of  the  education  of  the  people  for  the  restrictio 
of  dangerous  communicable  diseases.  There  was  considerable  work  i 
connection  with  the  brief  abstract  of  the  January  meeting,  and  on  otkt 
subjects. 

There  were  1,106  pages  of  letter-book  used  in  copying  the  corresponc 
ence  of  the  office,  not  including  many  postal  cards  which  have  been  ser 
out  but  not  copied  in  the  letter-book. 

Distribution  of  Publications , etc. 

About  1,100  copies  of  the  Abstract  of  the  Sept.  29  and  30,  1893,  meet 
ing,  and  about  1,200  copies  of  the  Abstract  of  Proceedings  of  the  Jan.  IS 
1894,  meeting  of  this  Board,  have  been  sent  to  members  and  ex- member 
of  this  Board,  sanitary  journal  exchanges,  meteorological  observers  an1 
meteorological  exchanges,  members  of  State  Boards  of  Corrections  an* 
Chanties,  secretaries  of  State  Boards  of  Health,  secretaries  of  State  Med 
ical  Societies,  libraries,  newspapers,  and  health  officers  in  other  States. 

About  1,500  copies  of  the  printed  proceedings  of  the  Hillsdale  Sanitar 
Convention  were  distributed  to:  Officers  and  participants  of  the  Conven 
tion,  members  and  ex-members  of  this  Board,  secretaries  of  State  Board 
of  Health  and  of  State  Medical  Societies,  sanitary  journal  exchanges 
members  of  State  Boards  of  Corrections  and  Charities,  secretaries  of  pre 
vious  sanitary  conventions,  libraries,  newspapers,  and  health  officers  ii 
other  States. 

That  portion  of  the  printed  abstract  of  the  Jan.,  1894,  meeting  of  .thii 
Board,  which  referred  to  the  establishment  of  chairs  of  sanitarv  science 


ABSTRACT  OP  PROCEEDINGS,  APRIL  13,  1894. 


17 


s marked,  and,  together  with  the  Hillsdale  Sanitary  Convention  pro- 
dings  and  the  paragraph  quoted  from  the  title  page  of  the  annual 
)ort  of  the  Australian  Health  Society,  was  sent  to  members  ol  faculties 
all  colleges  in  Michigan,  members  of  the  State  Board  of  Agriculture, 
incipals  of  high  schools  and  superintendents  of  graded  schools  in 

Aboutthe  usual  numbers  of  pamphlets  on  the  restriction  and  prevention 
the  different  dangerous  communicable  diseases  were  sent  to  the  health 
leers  of  localities  from  which  dangerous  diseases  had  been  reported,  it 
,s  at  the  same  time  requested  of  these  health  officers  that  the  pamphlets 
distributed  to  the  neighbors  of  the  persons  sick  with  such  diseases,  and 
such  other  places  as  they  would  be  likely  to  do  good. 

By  special  request  of  sanitarians  in  this  and  other  otates,  copies  o 
mual  Beports,  proceedings  of  meetings  and  sanitary  conventions,  and 
mphlets  on  the  restriction  and  prevention  of  the  dangerous  diseases, 
ve  been  sent  where  it  was  thought  practicable  and  likely  to  benefit  pub- 
, health  interests. 


teturn  of  the  Name  and  Postoffice  Addresses  of  Health  Officers, 

for  the  year  1894-95. 

Envelopes  to  the  number  of  1,930  have  been  addressed  to  supervisors  of 
wnships,  presidents  and  clerks  of  villages,  and  mayors  and  clerks  o 
ties  in  Michigan.  These  envelopes  were  used  for  sending  to  these 
ficials  a circular  letter  of  instructions,  together  with  a form  and  addressed 
ivelope  for  the  return  to  the  Secretary  of  the  State  Board  of  Health,  of 
»e  name  and  postoffice  address  of  the  newly  appointed  health  officer  m 
■cordance  with  the  State  law. 

Annual  Beports  from  Health  Officers  and  Clerks,  for  1893. 

| Annual  reports  for  the  year  1893  have  been  received  from  1,123  health 
| ficers  and  from  1,053  clerks  of  townships,  cities  and  villages  m Michigan, 
hese  reports  convey  to  this  office  information  relative  to  the  prevalence 
• each  dangerous  communicable  disease,  and  the  condition  of  health,  and 
! health  work  in  each  jurisdiction.  Also,  the  name,  postoffice,  address, 

1 3ar  of  graduation,  and  the  school  of  medicine  to  which  each  medical  prac- 
! tioner  in  the  township,  city  or  village  belongs.  ,.7 

On  February  21,  a “ Second  request  for  annual  report  was  sent  to  44 1 
i sal th  officers  and  clerks  from  whom  no  report  had  yet  been  received;  and 
:-i  March  24,  a “ Third  request  ” was  sent  to  284  health  officers  and  clerks 
\l  cities  and  villages,  who  were  still  delinquent. 

! On  March  14,  a “ Second  request  for  annual  report  was  sent  to  l,Ui« 
j ealth  officers  and  clerks  of  townships  from  whom  no  report  had  been 
hceived.  Many  of  the  reports  from  townships  have  been  received,  but  a 
Third  request”  will  soon  be  sent  out  to  those  still  delinquent, 
j Of  the  1,578  localities  in  Michigan,  including  townships,  cities  and  vil- 
i iges,  annual  reports  have  been  received  from  1,397,  leaving  at  the  end  ot 
■ lis  quarter  181  localities  delinquent.  More  reports  are  expected;  and, 
j ompared  with  preceding  years,  there  is  a smaller  number  of  delinquent 
} icalities 

} Beports  of  medical  practitioners  in  their  jurisdictions  have  been  received 
j com  501  clerks  of  townships,  cities  and  villages. 


18 


MICHIGAN  STATE  BOARD  OF  HEALTH. 

Work  on  Meteorology. 

The  regular  tri-daily  meteorological  observations  have  been  continued  a 
this  station,  and  a summary  for  each  week  and  month  during  the  quarte: 
has  been  made  for  the  use  of  this  office  in  connection  with  sickness  statis 
tJcs-  .The  monthly  summary  has  been  sent  at  the  end  of  each  month  t< 
the  Director  of  the  Michigan  Weather  Service  and  Local  Forecast  Officia 
at  Detroit  for  his  use;  it  is  sent  by  him  to  the  Chief  of  the  U.  S.  Weathei 
Bureau  at  Washington,  D.  C. 

Ozone  test  paper  (supply  for  three  months)  was  sent  to  each  of  sixteei 
meteorological  observers  in  Michigan. 

Diagrams  “ Cases  and  Deaths  from  Scarlet  Fever  in  Michigan  in  1891 ' 
and  “ Reported  Deaths  from  Scarlet  Fever  in  Michigan,  24  years  1868-91” 
have  been  prepared,  and  photo- engraved  plates  made  to  be  used  in  the 
annual  report  of  this  Board  for  1892. 

Accessions  to  the  Library , Card-Cataloguing , etc. 

During  the  quarter  119  books  and  pamphlets  and  351  numbers  of 
journals  (weeklies,  monthlies,  and  quarterlies),  have  been  received  and 
entered  in  the  library-accession  book  of  this  office.  The  work  on  the 
card-catalogue  of  the  library  has  been  continued. 

Work  in  Connection  with  Sickness  Statistics. 

During  the  first  quarter  of  1894,  2,352  blank  postal  report-cards,  159  record 
books,  27  hektographed  circular  letters  and  18  printed  circulars  regard- 
ing weekly  card-reports,  have  been  mailed  to  152  health  officers  and  reg- 
ular  correspondents;  1,287  weekly  card-reports  have  been  received  and 
entered  on  the  register;  53  copies  of  the  hektographed  weekly  bulletin 
Health  m Michigan”  were  mailed  each  week,  and  106  copies  of  the 
monthly  bulletin  “Health  in  Michigan”  have  been  hektographed  and 
mailed  each  month.  These  bulletins  have  been  consolidated  for  this 
quarterly  report.  W^ork  has  also  been  done  on  the  compilation  of  the 
f766!  «QQCarC^'re^>0r^S  s^c^-ness  during  the  year  1892,  for  the  annual  report 


Health  in  Michigan  in  the  First  Quarter  of  1894.  Communicable 

Diseases. 

Compared  with  the  preceding  quarter,  (October,  November  and  Decem- 
ber),  reports  from  all  sources  show  scarlet  fever  to  have  increased  by  an 
average  of  nineteen  places,  diphtheria  to  have  decreased  by  an  average  of 
three  places,  typhoid  fever  to  have  decreased  by  an  average  of  forty-four 
places,  measles  to  have  increased  by  an  average  of  seventeen  places  and 
small-pox  to  have  increased  by  an  average  of  three  places. 

Meteorology  and  Sickness  from  all  Causes , First  Quarter  of  1894,  com- 
pared with  the  Preceding  Quarter. 

A comparison  of  meteorological  conditions  of  the  first  quarter  of  1894, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the  pre- 
vailing direction  of  the  wind  to  have  been  the  same  (southwest),  the  aver- 


ABSTRACT  OF  PROCEEDINGS,  APRIL  13,  1891. 


19 


ge  velocity  1.6  miles  per  hour  greater,  the  temperature  7.44  degrees 
□wer,  the  rainfall  at  Lansing  2.26  inches  less,  the  absolute  and  the  relative 
tumidity  considerably  less,  the  day  ozone  slightly  more,  the  night  ozone 
auch  less  and  the  depth  of  water  in  the  well  at  Lansing  two  inches  more 
a the  first  quarter  of  1894. 

Compared  with  the  preceding  quarter  (October,  November  and  Decem- 
•er),  the  reports  from  regular  observers  show  a marked  increase  of  pleuritis, 
aflammation  of  kidney,  pneumonia  and  influenza,  and  a marked  decrease 
f diarrhea,  remittent  fever  and  intermittent  fever  in  the  first  quarter  of 
894. 

fhe  Weather,  and  the  Health  in  Michigan  in  the  First  Quarter  of  1894, 
compared  with  the  Average  for  the  eight  years,  1886-1893. 

A comparison  of  the  meteorological  conditions  of  the  first  quarter  of 
894,  with  the  average  for  the  first  quarters  in  the  eight  years,  1886-1893, 
hows  that  in  1894,  the  prevailing  direction  of  the  wind  was  southwest 
instead  of  northwest),  the  velocity  was  1.6  miles  per  hour  greater,  the 
emperature  was  4.82  degrees  higher,  the  rainfall  at  Lansing  was  .54  of  an 
ich  less,  the  absolute  humidity  was  more,  the  relative  humidity  was  less, 
re  day  ozone,  and  the  night  ozone  were  much  less,  and  the  depth  of  water 
l the  well  at  Lansing  was  four  inches  more. 

Compared  with  the  average  in  thp  corresponding  quarters  in  the  eight 
ears  1886-1893,  the  reports  from  regular  observers  indicate  that  intermit- 
.at  fever,  remittent  fever,  erysipelas,  diarrhea,  consumption,  pneumonia 
nd  pleuritis  were  less  than  usually  prevalent,  and  that  no  disease  was 
lore  than  usually  prevalent  in  the  first  quarter  of  1894. 


ABSTRACT  OF  PROCEEDINGS 


OF  THE 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


REGULAR  MEETING  OCTOBER  12,  1894. 


[216J  [Reported  by  the  Secretary  of  the  Board.] 

The  Michigan  State  Board  of  Health  held  its  quarterly  meeting,  at  the 
office  of  the  Secretary,  in  the  Capitol,  at  Lansing,  Oct.  12,  1894.  The 
meeting  was  called  to  order  by  President  Frank  Wells  of  Lansing;  Prof. 
Fall  of  Albion,  Doctor  Vaughan  of  Ann  Arbor,  Doctor  Gray  of  Pontiac, 
Doctor  Milner  of  Grand  Bapids,  and  Secretary  Baker  of  Lansing,  were 
present.  Dr.  Henry  Sewall,  Secretary  of  the  Colorado  State  Board  of 
Health,  was  present  and  made  a few  appropriate  remarks  regarding  the 
organization  and  work  of  the  Colorado  Board,  the  law  for  which  was 
modeled  after  the  Michigan  law.  The  regular  business  including  the 
auditing  of  bills  and  accounts  was  transacted. 

Condition  of  Health  in  Michigan  during  the  third  quarter  of  1894. 

Secretary  Baker  reported  that  during  the  third  quarter  of  1894,  there 
has  been  an  unusual  prevalence  of  typhoid  fever,  which  has  not  been  con- 
fined to  Michigan ;!probably  connected  with  the  drouth  and  unusually  low 
water  in  wells.  Except  as  regards  typhoid  fever,  the  public  health  in 
Michigan  has  been  remarkably  good.  [His  quarterly  report  of  ^details  of 
dangerous  communicable1!  .diseases  dealt  with,  and  of  sickness  from  all 
causes  is  printed  at  the  close  of  these  “ Proceedings.”] 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


2 


The  Board  adopted  resolutions  drafted  by  Prof.  Fall,  as  follows: — 

Whereas,  The  members  of  the  State  Board  of  Health  have  heard  with  deep  regret,  that  ‘‘The  silent 
reaper  whom  men  call  Death”  has  removed  from  the  scene  of  his  life’s  activities  one  who  was  for  many 
years  a highly  esteemed  and  useful  member  of  this  Board,  therefore, 

Resolved , That  in  the  death  of 

HENRY  F.  LYSTER,  M.  D., 

the  more  immediate  and  intimate  circle  in  which  he  moved,  the  City  of  his  residence,  and  the  State  have 
suffered  a loss  which  is  severe  indeed.  His  influence  was  far  reaching  and  powerful  and  always  for  the 
good  of  those  on  whom  that  influence  rested. 

Resolved , That  the  members  of  this  Board,  his  associates  for  so  many  years  desire  to  place  on  record 
their  high  appreciation  of  his  great  work  to  the  cause  of  sanitary  reform.  To  this  cause  he  gave  freely  of 
his  wealth  of  time  and  talents.  He  was  peculiarly  fitted  to  further  the  work  of  education  of  the  people 
on  the  lines  of  sanitary  science.  He  was  cultured  and  versatile  an  entertaining  lecturer,  an  extensive 
traveler  and  wide  observer  of  men  and  affairs,  and  all  these  he  contribute  to  his  work  for  the  good  of 
others.  , 

Resolved , That  we  tender  the  bereaved  family  our  most  heartfelt  sympathy. 

Resolved , That  these  resolutions  be  spread  on  the  minutes  of  the  Board,  and  that  a copy  be  sent  to  the 
friends  of  the  deceased. 

Report  of  Delegate  to  International  Congress  of  Hygiene. 

Prof.  Victor  C.  Vaughan,  M.  D.,  Ph.  D.,  Director  of  the  Michigan  State 
Laboratory  of  Hygiene,  made  a verbal  report  of  his  attendance  at  the 
International  Congress  of  Hygiene,  at  Budapest,  Hungary,  Sept.  1-9.  A 
brief  synopsis  is  as  follows: 

The  Congress  met  Sept.  1 for  registration,  and  was  officially  opened 
Sept.  2,  in  the  great  Hall  of  the  Municipal  Building,  by  Archduke  Charles 
Louis,  acting  for  his  brother,  the  Emperor.  There  were  short  addresses 
from  representatives  of  different  Nations,  and  a memorial  address,  Sept.  2 
being  the  anniversary  of  the  death  of  the  Hungarian  physician  who  first 
inaugurated  the  use  of  antiseptic  surgery,  in  obstetrical  cases.  The  Con- 
gress was  divided  into  some  twenty-five  sections,  and,  of  course,  it  was 
impossible  for  one  man  to  attend  sections  other  than  those  on  the  subjects 
of  most  interest  to  him.  There  were  delegates  to  the  Congress  from  nearly 
every  civilized  and  semi-civilized  country  in  the  world,  being  about  2,000 
delegates  in  all,  of  whom  eight  were  from  the  United  States  of  America. 

In  the  section  on  Bacteriology,  Prof.  Buchner  of  Munich,  opened  the 
discussion  of  the  subject  of  the  germ  theory  of  disease,  and  was  followed 
by  Metschnikoff,  the  father  of  the  theory  of  Phagocytosis.  Both  these 
great  men  gave  their  views  on  immunity  and  it  was  plainly  seen  that  their 
views  were  getting  closer  together.  Prof.  Fodor,  of  Budapest,  read  a paper 
on  the  alkalinity  of  the  blood,  and  I read  a paper  on  Nucleins.  It  is 
gratifying  to  say  that  the  work  for  the  production  of  immunity  by  the  use 
of  nucleins  is  shaping  itself  into  a tangible  form.  The  Section  on  Bacteri- 
ology was  largely  attended  by  the  prominent  bacteriologists  in  the  world. 

Prof.  Gruber  of  Budapest  said  that  the  Comma  bacillus  is  a cause  of 
cholera,  but  there  is  something  else  that  plays  an  important  part  in  the 
causation  of  cholera.  Prof.  Metschnikoff  detailed  his  experiments  with 
the  cholera  germ,  the  results  of  which  go  to  prove  that  cholera  is  due  to  a 
mixed  infection,  the  Comma  bacillus  being  the  principal  factor,  and  yet 
that  the  cholera  germ  may  be  present  without  cholera.  Dr.  Vaughan 
explained  by  saying  that  if  X equals  the  cholera  germ,  Z the  personal 
peculiarity  of  susceptibility,  Y is  what  has  been  the  missing  link,  which 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  12,  1894. 


3 


has  just  been  discovered  by  Metschnikoff  to  be  the  mixed  infection,  the 
Comma  bacillus  with  the  Sarcince,  or  with  the  putrefactive  germs. 
Metschnikoff  said  that  two  years  ago  the  cholera  bacillus  was  present  in 
the  river  Seine  without  the  presence  of  cholera  among  those  who  drank  its 
waters,  showing  that  the  necessary  mixed  infection  was  not  present.  Koch’s 
school  has  advocated  or  implied  that  filth  has  nothing  to  do  with  the 
causation  of  cholera  and  typhoid  fever,  but  the  section  on  bacteriology 
seemed  to  favor  the  idea  that  too  little  attention  has  been  given  to  filth  as 
a factor  in  the  causation  of  these  diseases.  I never  saw  such  enthusiasm 
over  a paper  as  there  was  over  the  one  read  by  Metschnikoff.  There  were 
only  a few  reprints  of  his  paper,  and,  notwithstanding  the  paper  would 
be  printed  in  a few  days,  the  leading  bacteriologists  scrambled  over  the 
tops  of  the  seats  to  get  a copy  of  the  reprint. 

A paper  prepared  by  Dr.  Behring  on  his  experiments  in  connection 
with  his  work  on  immunity  from  diphtheria  was  presented,  and  read  to  the 
Congress  by  Dr.  Heubner  of  the  University  of  Berlin.  The  paper  detailed 
his  experiments  in  rendering  goats  immune  against  diphtheria,  and  then 
taking  the  immunizing  blood-serum  of  the  goat  for  the  treatment  of  diph- 
theria in  the  human  being.  Dr.  Roux,  of  the  Paris  Pasteur  Institute,  read 
a paper  on  nearly  the  same  subject,  except  that  he  had  used  horses  in  his 
experiments,  and  had  taken  the  immunizing  blood-serum  of  the  horse  for 
the  treatment  of  diphtheria.  While  Dr.  Behring  left  his  method  prac- 
tically a secret,  Dr.  Roux  revealed  every  detail  of  his  work,  and  offered  to 
supply  the  serum,  and  made  known  his  intentions  to  give  his  time  to  the 
Prevention  of  Diphtheria.  Under  Dr.  Roux’s  direction,  in  Paris,  some  400 
diphtheria  cases  had  been  treated,  with  a mortality  of  only  15  per  cent, 
which  was  a reduction  from  a mortality  of  55  or  60  per  cent  prior  to  the 
great  discovery.  Although  Dr.  Roux  has  not  had  time  to  fully  prove  his 
method,  he  will  make  many  hundreds  of  tests  of  his  treatment  before  stat- 
ing absolutely  as  regards  its  efficacy. 

In  the  discussion  of  the  subject  of  the  restriction  and  prevention  of 
diphtheria,  Dr.  Billings,  Deputy  Surgeon-General  of  the  United  States 
Army,  presented  a paper  which  had  been  written  by  Dr.  Welch,  Bacter- 
iologist at  Johns  Hopkins  University,  Baltimore,  giving  not  only  his  own 
researches,  but  the  work  of  others  in  the  Eastern  States  of  this  Union.  It 
was  apparent  that  all  the  best  work  in  connection  with  the  pre- 
vention of  diphtheria  has  been  done  in  the  United  States,  and  that  no 
city  or  country  has  done  so  much  as  has  been  done  in  the  city  of  New 
York  in  connection  with  the  bacteriological  diagnosis  of  diphtheria.  His 
paper  showed  that  out  of  6,000  cases  in  which  the  bacteriolgical  examina- 
tion had  been  made,  60  per  cent  were  found  to  be  diphtheria  and  were  so 
treated  by  the  Health  Department,  and  the  rest  were  discharged  as  not 
being  diphtheria. 

Dr.  Leyden  read  a paper  on  the  “ Prevention  of  Tuberculosis,”  which 
was  one  of  the  most  important  papers  of  the  Congress.  Dr.  Leyden  said 
that  tuberculosis  was  a communicable  disease,  and  in  the  homes  of  the 
poor  covuld  be  restricted  only  by  the  withdrawal  of  the  sick  from  the  family, 
and  isolation  in  consumptive  hospitals.  He  advocated  two  classes  of 
hospitals,  one  for  the  incurable,  and  one  for  the  curable  cases.  He  showed 
that  the  expense  of  caring  for  a consumptive  in  a hospital  was  about  62^ 
cents  per  day.  Dr.  Vaughan  said  that  he  was  surprised  to  hear  that  there 
were  several  free  government  hospitals  for  consumptives  already  in 
operation  in  Germany. 

2 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


Telegraphic  reports  announced  that  Kitasato,  of  Japan,  had  discovered 
the  germ  of  Asiatic  Plague;  but  Yersin,  of  France,  had  already  sent  word 
of  his  discovery  to  the  Congress,  together  with  plates  and  cultures  of  the 
germs.  The  four  rules  of  Koch  have  been  fully  complied  with,  so  there  is 
probably  no  doubt  but  that  the  germ  has  been  discovered  by  Yersin,  and 
that  Kitasato  has  verified  the  discovery.” 

It  was  voted  by  the  Board  to  thank  Dr.  Vaughan  for  his  verbal  report, 
and  to  request  that  he  make  his  written  report  as  soon  as  practicable. 

The  Production  of  Immunity  against  Diphtheria. 

Dr.  Vaughan  asked  the  Board  what  it  wished  to  do  in  connection  with 
the  Prevention  or  Restriction  of  Diphtheria,  by  the  use  of  immunizing 
blood-serum.  He  believed  that  great  progress  in  our  knowledge  of  this 
subject,  could  be  made  in  Michigan  by  being  able  to  supply  health  officers 
and  physicians  with  the  immunizing  blood-serum. 

On  motion  of  Dr.  Baker,  it  was  voted  that  Dr.  Vaughan — the  Director 
of  the  Michigan,  State  Laboratory  of  Hygiene — be  requested,  if  practicable, 
to  enter  upon  the  production  of  immunizing  blood-serum  for  use  in  the 
production  of  immunity  from  diphtheria,  with  a view  of  still  further 
testing,  in  this  country,  the  efficacy  of  the  method. 

The  Disinfection  of  Solid  Masses  of  Dried  Tuberculous  and  Diphtheritic  Sputa. 

The  question  of  a disinfectant  which  shall  destroy  the  germs  in  a solid 
dried  mass  of  tuberculous  or  diphtheritic  sputum  was  presented,  from  a 
prominent  health  officer  in  Michigan,  Dr.  Johnston,  of  Milford.  On 
motion,  the  Board  voted  to  request  Dr.  Vaughan  to  make  such  investiga- 
tions as  will  settle  the  point  whether  sulphur  fumes  will  penetrate  a dried, 
solid  tuberculous  or  diphtheritic  sputum,  as  it  is  generally  found  when 
deposited  on  a trunk  of  an  immigrant  or  on  the  floor.  If  sulphur  fumes 
are  not  adequate  for  such  disinfection,  to  test  so  as  to  learn  just  what 
mode  of  disinfection  is  adequate. 

A N on-Infectious  Public  Drinking  Cup  for  Schools. 

The  subject  of  the  contraction  of  diphtheria  and  other  diseases  by  means 
of  public  drinking  cups  was  presented  and  discussed,  by  reason  of  a commu- 
nication to  the  Secretary  from  Dr.  G.  W.  Goler,  medical  inspector,  board 
of  health,  Rochester,  N.  Y.  Dr.  Baker  read  an  account  of  the  actual 
demonstration  of  diphtheria  bacilli  on  two  cups  in  actual  use  in  a school. 
The  value  of  public  drinking  fountains,  such  as  have  been  in  use  in  New 
York  City,  and  similar  to  one  in  Romeo,  Michigan,  was  considered.  The  cups 
are  stationary  on  the  top  of  the  open  end  of  the  water  pipe,  the  water 
rising  in  the  center  and  flowing  over  the  edges.  When  in  use 
running  water  continually  overflows  the  sides  of  the  public  cup  and  tends 
to  wash  away  any  infectious  material  that  otherwise  collects  upon  the 
edges  and  sides  of  the  cup.  Whenever  there  is  a general  water  supply 
with  pressure  a similar  fountain  cup  might  easily  be  attached  to  the  pub- 
lic drinking  place  for  school  children,  and  it  would  tend  to  prevent  the 
spread  of  diphtheria,  and  other  diseases  of  specific  origin. 


ABSTRACT  OP  PROCEEDINGS,  OCTOBER  12,  1894. 


5 


Consumptives  Should  not  he  School  Teachers. 

Dr.  Milner,  of  Grand  Rapids,  said  that  he  had  noted  several  instances 
where  school  children  had  probably  contracted  consumption  from  their 
teacher.  Dr.  Milner  moved  that  the  Board  request  the  committee  on 
public  health  legislation  to  frame  a bill  for  the  next  legislature,  which 
shall  prohibit  any  person  from  teaching  school  or  acting  as  a professional 
nurse  without  having  the  certificate  from  a reputable  physician  stating 
that  the  proposed  teacher  or  nurse  is  free  from  any  communicable  form  of 
tuberculosis. 


Milk  of  Tuberculous  Animals  Should  not  he  Sold. 

Dr.  Vaughan  suggested  that  the  committee  on  legislation  be  requested 
to  frame  a law  which  should  prohibit  a milkman  from  selling  milk  in  a 
city  unless  he  has  a license  from  the  State  Live  Stock  Commission  show- 
ing that  his  cows  have  been  examined  by  the  State  Veterinarian,  or  a com- 
petent veterinarian,  and  found  to  be  free  from  tuberculosis,  the  tuberculin 
test  being  applied  in  case  of  any  doubt. 

Proposed  Systematic  Observations  of  Carbonic  Acid  in  the  Atmosphere. 

Prof.  Fall,  of  Albion,  committee  to  whom  was  referred  the  subject  of 
fluctuations  in  the  amount  of  carbonic  acid  gas  in  the  atmosphere,  made  a 
preliminary  report  on  the  instruments  and  apparatus  needed  to  make  reg- 
ular and  accurate  examinations  to  determine  the  amount. 

The  written  portion  of  Prof.  Fall’s  report  is  as  follows: 

Carbon  di  oxide  in  the  atmosphere. 

At  the  quarterly  meeting  of  this  Board  held  July  13,  1894,  Secretary  Baker,  as  Com- 
mittee on  Climate,  etc.,  presented  the  subject  of  the  “Decrease  of  the  amount  of  Car- 
bon Di-oxide  in  the  atmosphere,”  and  remarked  that  some  twenty  years  ago  he  had 
asked  the  Board  to  authorize  a series  of  regular  and  accurate  chemical  analyses  of  the 
atmosphere  with  a view  of  determining  whether  there  was  any  change  in  the  amount 
of  the  carbonic  acid  gas  in  the  atmosphere  by  seasons  of  the  year  and  by  long  periods 
of  years.  Dr.  Baker  said  that  the  subject  is  important  now  and  may  become  more  so, 
in  relation  to  the  public  health.  He  quoted  from  the  Chemical  News , London,  August, 
1893,  as  follows:  As  evidence  that  the  composition  of  the  atmosphere  is  still  slowly 
changing,  it  is  stated  that  “ the  latest  and  most  careful  determinations  of  carbonic 
acid  in  the  air  have  shown  a decided  decrease  (0.05  to  0.03)  in  the  past  fifty  years.” 

On  the  other  hand,  Dr.  Paul  C.  Freer,  Professor  of  Chemistry  in  Michigan  Univer- 
sity, says,  in  his  General  Chemistry,  just  published,  that  “so  far  as  we  know,  the 
amount  of  carbon  di-oxide  in  the  atmosphere  is  not  diminishing;  if  it  is  growing 
less  the  rate  of  decrease  is  so  very  slow  that  in  the  short  time  that  chemists  have  been 
able  to  make  accurate  observations,  no  change  could  be  noted.”  He  further  says:  “ The 
amount  of  carbon  dioxide  in  the  air  varies  slightly,  but  normally  it  is  about  four  parts 
in  ten  thousand,  and  it  seems  that  the  amount  is  greater  at  night  than  in  the  daytime, 
and  in  summer  than  in  winter.  In  the  higher  regions  of  the  atmosphere,  where  vege- 
tation is  impossible,  the  amount  of  the  gas  may  increase  to  eleven  parts  in  ten  thousand, 
while  a continued  rain  may  diminish  it  to  two  and  a quarter.” 

The  report  was  accepted  with  thanks,  and  the  committee  continued. 
Dr.  Baker  was  very  enthusiastic  in  his  plea  that  the  observations  be  com- 
menced and  continuously  made,  so  that  the  facts  be  known  and  recorded 
for  future  use  in  connection  with  studies  on  the  causation  of  diseases,  with 
a view  to  their  prevention. 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


THE  STATE  QUARANTINE  LAW. 

The  law  is  constitutional. 

The  Secretary  reported  as  follows: — 

“ During  the  quarter,  the  State  Supreme  Court  has  decided  the  question 
of  the  constitutionality  of  the  law  which  authorizes  the  State  Board  of 
Health,  under  certain  circumstances  4 to  establish  a system  of  quarantine 
for  the  State  of  Michigan  or  for  any  portion  thereof.’ 

“ The  court  decides  that  the  law  is  constitutional. 

Rule  2 of  this  Board , under  the  State  Quarantine  Law , is  not  valid. 

“The  ‘circumstances’  specified  in  the  law,  as  warranting  the  State 
Board  of  Health  in  establishing  a system  of  quarantine,  are  such  as  gen- 
erally prevail  in  every  country,  it  being  within  the  knowledge  of  this 
Board  through  its  system  of  exchanges  of  weekly,  monthly  and  other 
reports,  etc.,  throughout  the  world,  that  such  ‘ dangerous  communicable 
diseases’  specified  in  the  law,  are  now  and  are  generally  present  in  every 
country.  This  was  true  at  the  time  this  Board  made  and  published  the 
‘Buies’  under  this  State  quarantine  law.  It  was  also  true  relative  to 
cholera,  which,  although  not  the  most  dangerous  disease  to  citizens  of  Mich- 
igan, is  yet  one  of  such  “dangerous  communicable  diseases”  contemplated 
by  the  law;  cholera  was  then  liable  to  be  brought  to  this  country  by  any 
immigrant  from  any  country,  because  of  the  diffusion  of  cholera  inso  many 
centers  of  distribution  of  immigrants.  But  in  this  declaration  of  the  ‘cir- 
cumstances’ upon  which  this  Board  based  its  ‘Buies’  made  under  the  law, 
these  facts  were  not  advertised.  Without  making  plain  the  fact  that  there 
was  then  danger  of  the  introduction  of  a ‘dangerous  communicable  dis- 
ease’from  every  country,  the  ‘Buie  2’ required  the  disinfection  of  all 
baggage  of  all  immigrants.  The  Supreme  Court  has  decided  that  ‘ Buie 
2’  as  made  and  published,  was  not  authorized  by  the  law. 

“ I hope  it  will  be  possible  to  frame  a rule  which  shall  be  authorized  by 
law,  and  which  shall  fill  the  requirements  for  protection  of  the  people  of 
Michigan  from  the  introduction  of  dangerous  disease. 

“Perhaps  it  may  be  sufficient  to  declare  that  such  diseases  are  present 
in  every  known  country.  But  this  may  not  be  sufficient;  and  the  framing 
of  a rule  may  not  be  as  easy  as  at  first  sight  it  appears. 

Is  the  State  Quarantine  Law  Sufficients 

“ When  immigration  increases  again,  danger  of  the  introduction  of  dis- 
ease may  and  probably  will  attend  all  baggage  of  all  immigrants.  Unless 
the  law  is  amended,  it  may  be  necessary  to  specify,  by  name,  every  known 
country,  and  not  only  that  but  the  names  of  the  particular  dangerous  dis- 
eases present  in  each  such  country.  Probably  this  may  be  done;  but  in 
an  emergency  it  might  delay  proper  action  by  this  Board. 

“The  theory  of  the  law  seems  to  me  to  be  wrong.  It  seems  to  assume 
that  if  there  is  no  dangerous  communicable  disease  in  a given  country  it 
is  entirely  safe  to  permit  immigrants  from  that  country  to  enter  Michigan 
without  any  precaution  whatever.  This  theory  is  probably  held  to  be  true 
by  most  people,  including  courts  and  juries,  but  it  entirely  disregards 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  12,  1894. 


< 


important  facts  relative  to  the  modes  of  spreading  dangerous  communica- 
ble diseases: — 

“1.  An  immigrant  may  come  from  a place  free  from  infection  of  any 
dangerous  disease,  and  his  baggage  may  become  infected  on  shipboard  or 
at  some  center  of  embarkation  or  debarkation  where  immigrants  from 
many  countries  congregate.  He  may  himself  be  immune  against  a given 
disease,  and  thus  himself  be  free  from  any  evidence  of  infection;  yet  his 
baggage  when  opened  in  the  home  of  some  inhabitant  of  Michigan  may 
spread  a dangerous  disease. 

“2.  An  immigrant  may  really  come  from  a place  which  is  infected  with 
a dangerous  disease,  yet  his  place  of  embarkation  may  be  in  a country,  or 
at  least  in  a city  in  which  the  particular  disease  with  which  his  baggage 
is  infected  may  not  be  present.  If  he  is  considered  as  from  the  country 
in  which  he  embarked,  he  will  be  considered  as  free  from  the  infection 
which  in  reality  his  baggage  contains. 

“ There  are  other  facts  bearing  upon  the  subject,  which  are  well  known 
to  members  of  this  Board,  but  those  I have  mentioned  seem  to  be  suffi- 
cient to  indicate  the  imperfection  in  the  theory  of  the  State  Quarantine 
Law.” 

“The  decision  of  the  Supreme  Court  is  as  follows: — 

DECISION  OF  THE  SUPREME  COURT. 

SUPREME  COURT. 

John  Hurst, 
vs. 

Frank  R.  Warner. 

Montgomery,  J. 

The  plaintiff,  who  is  prosecuting  attorney  for  the  county  of  Chippewa,  on  the  twenty-fourth  of  Novem- 
ber, 1893,  presented  to  the  respondent,  who  is  a justice  of  the  peace  of  said  county,  a complaint  alleging 
that  one  Robert  B,  Finch  was  a station  agent  of  the  Minneapolis,  St.  Paul  & Sault  Ste.  Marie  R.  R.  Co.  at 
Sault  Ste.  Marie,  and  on  the  twenty-third  of  November,  1893,  in  charge  of  a train  belonging  to  said  rail- 
way company;  that  on  said  train  there  was  baggage  consisting  of  clothing,  wearing  apparel,  etc.,  belong- 
ing to  one  Edmund  Watelet,  an  immigrant,  late  of  Havre,  France,  who  was  traveling  through  Michigan 
to  Minneapolis  and  whose  baggage  was  liable  to  be  disinfected  by  one  Thomas  N.  Rogers,  an  inspector, 
authorized  by  the  Michigan  State  Board  of  Health,  of  all  immigrants  destined  to  pass  into  or  through  the 
State  of  Michigan;  that  said  Finch  was  requested  by  said  Rogers  to  detain  said  baggage  for  disinfection 
and  inspection  and  wilfully  refused  so  to  do  and  proceeded  with  said  train  and  said  baggage  in  and 
through  Michigan,  in  violation  of  rule  number  two,  framed  and  published  by  the  Michigan  State  Board 
of  Health,  under  act  number  230  of  the  laws  of  1885,  as  amended  by  act  number  47  of  the  laws  of  1893  of 
this  State.  Upon  the  presentation  of  this  complaint  the  respondent  was  requested  by  the  relator  to  cause 
a warrant  to  be  issued,  based  upon  said  complaint,  but  declined  to  do  so  for  the  reason  that  act  number 
47  of  the  laws  of  1893  was  unconstitutional  and  void,  and  for  the  further  reason  that  if  said  act  was  not 
void,  rule  number  two,  upon  which  the  prosecution  was  based,  was  not  authorized  by  said  act,  and  that 
the  Board  of  Health  exceeded  its  authority  in  passing  said  rule.  The  relator  then  applied  to  the  circuit 
judge  for  a mandamus,  which  was  refused,  and  certiorari  has  been  issued  to  review  his  decision.  The  two 
questions  presented  here  are  those  which  determined  the  action  of  the  justice. 

I.  It  is  contended,  and  the  circuit  judge  held,  that  the  statute  in  question  is  unconstitutional  for  the 
reason  that  it  delegates  to  the  Board  of  Health  legislative  power  in  contravention  of  section  one  of 
article  four  of  the  Constitution,  which  provides  that  “ legislative  power  is  vested  in  a senate  and  a house 
of  representatives.”  To  determine  the  question  involved  it  is  necessary  to  refer  at  some  length  to  the 
provisions  of  the  statute. 

Section  one  provides  that  “ whenever  it  shall  be  shown  to  the  satisfaction  of  the  State  Board  of  Health 
that  cholera,  diphtheria,  or  other  dangerous,  communicable  disease  exists  in  any  foreign  country,  neigh- 
boring state,  or  locality  within  this  State  whereby  the  public  health  is  imperiled,  and  it  shall  be 


| Filed  Sept.  27,  1894. 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


farther  shown  that  immigrants,  passengers,  or  other  persons  seeking  to  enter  this  State,  or  to  travel  from 
place  to  place  within  this  State,  are  coming  from  any  locality  where  such  dangerous,  communicable  dis- 
ease exists,  and  are  likely  to  carry  infection  of  such  dangerous,  communicable  disease,  the  State  Board  of 
Health  shall  be  authorized  to  establish  a system  of  quarantine  for  the  State  of  Michigan  or  for  any  portion 
thereof.” 

Section  two  provides  that  “ 6uch  quarantine  shall  be  for  the  purpose  of  preventing  all  immigrants,  pas_ 
sengers  or  other  persons,  under  the  circumstances  mentioned  in  section  one  of  this  act,  from  entering  the 
State  or  from  going  from  place  to  place  within  the  State,  who  in  the  opinion  of  the  State  Board  of  Health, 
or  in  the  opinion  of  an  inspector  duly  appointed  by  said  Board,  are  likely  to  carry  infection  of  cholera, 
small-pox,  diphtheria,  or  other  dangerous,  communicable  disease;  and  for  the  detention  of  all  such  per- 
sons outside  the  borders  of  the  State,  or  if  already  within  the  State,  at  the  places  where  they  may  be  or  at 
the  place  they  have  been  exposed  to  or  have  contracted  such  dangerous,  communicable  disease  or  at  such 
suitable  place  as  such  board  may  provide,  during  the  period  of  the  incubation  of  such  disease,  or  of  its 
existence  if  already  developed,  and  until  in  the  opinion  of  the  State  Board  of  Health  such  persons  are  free 
from  all  danger  of  infection.” 

Section  three  provides  that  “ the  State  Board  of  Health  is  authorized  to  establish  general  rules,  and,  by 
an  inspector  acting  by  virtue  thereof,  to  detain  railroad  cars  or  other  public  or  private  conveyances 
whenever  it  shall  be  shown  to  the  satisfaction  of  such  Board,  or  to  the  inspector  as  provided  in  such 
rules,  that  such  cars  or  other  conveyances  contain  any  passenger,  person  or  property  which  has  been 
exposed  to  cholera,  diphtheria,  or  other  dangerous,  communicable  disease,  or  when  it  shall  be  shown  to 
the  satisfaction  of  such  board  or  inspector  as  aforesaid,  any  [passenger,  person  or  property  are  being 
transported  on  such  railroad  cars  or  other  public  or  private  conveyance  from  any  locality  within  or  with- 
out this  State  where  any  such  dangerous,  communicable  disease  exists  and  where  under  the  circumstances 
shown  to  such  board,  such  persons  or  property  are  likely  to  carry  infection  of  such  dangerous,  com- 
municable disease.  In  such  case  said  board  may,  by  its  duly  constituted  inspectors,  remove,  isolate, 
place  under  the  care  of  local  boards  of  health,  order  to  be  returned  to  the  places  whence  they  came,  or 
dispose  of  in  any  other  manner  it  may  consider  proper,  all  railroad  cars  or  other  conveyances,  all  pas- 
sengers in  such  railroad  cars  or  other  conveyances,  where  there  is  reason,  as  aforesaid,  to  believe  such 
may  have  contracted  or  become  infected  with  any  dangerous,  communicable  disease,  or  have  been  exposed 
or  infected  by  any  such  disease  in  a manner  likely  to  render  them  bearers  of  infection.  * * * * * .” 

Section  four  provides,  “All  such  persons,  their  baggage  and  other  personal  effects,  and  all  such  con- 
veyances shall  be  disinfected  under  such  rules  and  regulations  as  the  State  Board  of  Health  may 
establish  for  the  purpose  of  carrying  into  effect  the  provisions  of  this  act,  before  such  persons  or  baggage 
or  conveyances  shall  be  permitted  to  enter  the  State,  or  to  proceed  to  their  or  its  destination  if  already 
in  the  State.” 

Section  five  provides  for  the  disinfection  of  goods,  merchandise,  conveyance  or  other  property  which 
the  State  Board  have  reason  to  believe  may  carry  the  germs  of  cholera  or  other  dangerous  communicable 
diseaee,  and  under  the  circumstances  mentioned  in  sections  two  and  three  of  the  act,  to  prohibit  the 
entry  of  such  goods,  merchandise  or  other  property  into  the  State,  or  their  being  moved  if  within  the 
State,  until  such  disinfection  shall  be  accomplished. 

Section  six  provides,  “ It  shall  be  the  duty  of  the  State  Board  of  Health  to  frame  and  publish  rules  for 
the  inspection,  isolation,  detention  and  disinfection  contemplated  in  this  act;”  and  further  provides  as 
follows:  “ Whoever  shall  wilfully  violate  the  rules  of  the  State  Board  of  Health  made  in  pursuance  of 
this  act,  or  the  order,  by  its  duly  appointed  inspector,  made  in  obedience  to  such  rules,  shall  be  deemed 
guilty  of  a misdemeanor,  and  cn  conviction  thereof  shall  be  liable  to  payment  of  a fine  of  one  hundred 
dollars  and  costs  of  prosecution,  or  imprisonment  in  the  county  jail  for  a period  not  to  exceed  ninety 
days,”  etc. 

As  was  said  by  Chief  Justice  Marshal  in  Wayman  v.  Soythard,  10  Wheaton,  1.  “ It  will  not  be  contended 
that  Congress  can  delegate  to  the  courts  or  to  any  other  tribunals,  powers  which  are  strictly  and  exclu- 
sively legislative.  But  Congress  may  certainly  delegate  to  others  powers  which  the  legislature  may  right- 
fully exercise  itself.  * * * The  difference  between  the  departments  undoubtedly  is  that  the 

legislature  makes  the  executive  executes  and  the  judiciary  construes  the  law.  But  the  maker  of  the  law 
may  commit  something  to  the  discretion  of  the  other  departments,  and  the  precise  boundary  of  this  power 
is  a subject  of  delicate  and  difficult  inquiry.” 

In  In  Re  Griner,  16  Wis.,  457,  Justice  Cole,  speaking  for  the  court  and  referring  to  the  rule  that  the  powers 
of  the  different  departments  are  not  to  be  confounded  or  delegated  by  the  one  department  to  the  other,  said, 
“ Most  of  the  propositions  stated  are  recognized  political  maxims  under  our  form  of  government.  It  is 
only  the  conclusion  or  deduction  from  those  propositions  about  which  any  doubt  can  exist.  No  one  will 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  12,  1894. 


9 


seriously  contend  that  congress  can  delegate  legislative  power  to  the  president.  Bnt  a distinction  must 
be  made  of  ‘ those  important  subjects  which  must  be  entirely  regulated  by  the  legislature  itself  from  those 
of  less  interest  in  which  a general  provision  may  be  made  and  power  given  to  those  who  are  to  act  under 
such  general  provisions  to  fill  up  the  detail.’  It  would  seem  that  the  power  given  to  the  president  to 
make  all  rules  and  regulations  to  carry  into  effect  the  law  for  calling  out  the  militia,  is  of  the  latter 
character.  Congress  might  have  regulated  by  legislstion  the  whole  details  of  the  draft,  if  it  had  thought 
proper  to  do  so.  But  having  in  the  most  ample  manner  clothed  the  president  with  power  to  call  forth 
the  militia,  it  further  provided  that  he  should  make  all  proper  rules  ond  regulations  for  the  enforce- 
ment of  the  draft  where  State  laws  upon  the  subject  were  defective.  *******  This 
no  more  partakes  of  legislative  power  than  that  discretionary  authority  entrusted  to  every  department 
of  the  government  in  a variety  of  cases.  The  practice  of  giving  discretionary  power  to  other  departments 
or  agencies  who  were  intrusted  with  the  duty  of  carrying  into  effect  some  general  provisions  of  the  law, 
had  its  origin  at  the  adoption  of  the  Constitution  and  in  the  action  of  the  first  congress  under  it,  as  the 
federal  legislation  abundantly  shows.” 

See  also  as  bearing  upon  this  question,  Field  v.  Clark,  12  S.  C.  R.,  495;  Locke’s  Case,  12  Pa.  St.,  491; 
Georgia  R.  R.  v.  Smith,  9 A.  R.  R.  Cases,  385. 

In  the  present  case  we  think  it  can  hardly  be  doubted  under  the  authorities  cited  that  the  legislature 
might  have  provided  for  the  disinfection  of  the  baggage  and  personal  effects  of  travelers  coming  from 
infected  ports,  under  the  direction  of  an  inspector  of  the  board.  To  have  made  such  a law  effective  it 
would  have  been  essential  that  the  inspector  should  have  been  given  authority  to  act  and  to  have  made  it 
a misdemeanor  to  refuse  to  recognize  his  authority.  The  present  act  does  nothing  more  except  that  it 
provides  that  such  disinfection  shall  take  place  under  general  rules  to  be  adopted  by  the  State  Board  of 
Health.  The  rules  relate  to  matter  of  detail.  It  is  well  known  that  there  are  different  methods  of  disin- 
fection. It  was  properly  left  to  the  board  by  the  legislature  to  determine  as  to  these  methods,  and  instead 
of  intrusting  it  to  the  discretion  of  the  individual  inspector  it  was  prescribed  that  general  rules  should 
be  adopted.  We  are  referred  to  the  case  of  the  Senate  of  the  Happy  Home  Club  v.  The  Board  of  Super- 
visors, 57  N.  W,  R.,  1101,  recently  decided  by  this  court,  as  authority  for  respondent’s  contention.  The 
statute  considered  in  that  case  bears  no  analogy  to  the  statute  under  consideration.  The  power  was  there 
delegated  to  a private  corporation  to  make  rules  governing  the  conduct  of  the  accused,  the  observance  of 
which  rule  should  operate  to  acquit  and  discharge  the  accused.  This  did  not  leave  a discretion  in  public 
officials  as  to  the  mere  details  of  the  operation  of  the  law,  but  was  an  attempt  to  delegate  power  to  a 
private  corporation,  which  it  was  clearly  beyond  the  authority  of  the  legislature  to  do.  Reliance  seems 
to  have  been  placed  by  the  circuit  judge  upon  two  cases  of  Ex  Parte  Cox,  33  Cal.,  21,  and  Harbor  Commis- 
sioners v.  Redwood  Co.,  88  Cal.,  491.  In  the  latter  case  an  attempt  was  made  to  confer  upon  the  board  of 
harbor  commissioners  the  power  to  prescribe  rules  and  fix  the  penalty  for  their  violation,  which  clearly 
distinguishes  it  from  the  present.  In  the  case  of  Ex  Parte  Cox,  the  petitioner  was  convicted  of  a misde- 
meanor consisting  of  a violation  of  a rule  and  regulation  of  the  board  of  State  Yiticultural  Commis- 
sioners. The  act  of  the  legislature  in  question  declared  that  the  board  should  have  power  to  declare  and 
enforce  rules  and  regulations  in  the  nature  of  quarantine  to  govern  the  manner  of  and  restrict  and  pro- 
hibit the  importation  into  the  State  of  infected  articles  and  empty  fruit  boxes,  and  declared  that  a wilful 
violation  of  the  quarantine  regulations  of  the  board  should  be  a misdemeanor.  The  court  say,  “ The  act 
before  us  does  not  say  it  shall  be  unlawful  to  import,  distribute  or  dispose  of  infected  articles,  but  it 
purports  to  confer  upon  the  board  the  power  to  so  declare.”  We  think  our  statute  is  distinguishable  in 
principle  from  the  one  here  dealt  with.  The  effect  of  the  provisions  of  our  statute  is  to  declare  it  unlaw- 
ful for  any  person  to  refuse  to  permit  his  baggage  and  personal  effects  to  be  disinfected  in  accordance 
with  the  rules  and  regulations  of  the  Board  of  Health.  The  rules  and  regulations  are  limited  to  the  pur- 
poses which  are  specifically  described  by  the  act.  We  think  the  statute  is  constitutional. 

II.  As  above  stated,  by  the  above  act  of  1893  it  was  not  intended  to  confer  upon  the  Board  any  power 
beyond  that  of  fixing  the  method  to  be  adopted  in  carrying  into  effect  the  details  of  the  isolation, 
inspection,  disinfection,  etc.,  provided  for  by  the  law  itself.  By  the  first  section  the  Board  was  author- 
ized to  establish  a quarantine  when  it  is  shown  to  the  satisfaction  of  the  Board  that  dangerous,  com- 
municable disease  exists  in  any  foreign  country,  neighboring  state  or  locality  within  this  State  and  when 
it  shall  be  further  shown  that  immigrants,  passengers,  or  other  persons  seeking  to  enter  this  State  or  to 
travel  from  place  to  place  within  this  State  are  coming  from  any  locality  where  such  dangerous,  com- 
municable disease  exists.  By  section  three  it  is  provided  that  “ the  State  Board  of  Health  is  authorized 
to  establish  general  rules,  and,  by  an  inspector  acting  by  virtue  thereof,  to  detain  railroad  cars  or  other 
public  or  private  conveyances  whenever  it  shall  be  shown  to  the  satisfaction  of  such  board  or  to  the 
inspector  as  provided  in  such  rules,  that  such  cars  or  other  conveyances  contain  any  passenger,  person 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


or  property  which  has  been  exposed  to  cholera,  diphtheria,  or  other  dangerous,  communicable  disease,  or 
when  it  shall  be  shown  to  the  satisfaction  of  such  board  or  inspector  as  aferesaid,  that  any  passeDger, 
person  or  property  are  being  transported  on  such  railroad  cars  or  other  public  or  private  conveyance 
from  any  locality  within  or  without  this  State  where  any  such  dangerous,  communicable  disease  exists 
and  where  under  the  circumstances  shown  to  such  board,  such  persons  or  property  are  likely  to  carry 
infection  of  such  dangerous,  communicable  disease.”  A careful  examination  of  the  rules  declared  by  the 
board,  and  particularly  of  the  one  alleged  to  have  been  violated,  leads  us  the  conclusion  that  the  board 
exceeds  the  authority  conferred  by  the  statute  by  the  promulgation  of  the  rule  in  question.  The  rules 
recite  the  existence  of  communicable  diseases  in  various  foreign  countries  from  which  immigrants  are 
coming  to  the  United  States  in  large  numbers,  and  then  proceeds  by  rule  two,  “ Except  as  hereinafter 
specifically  excepted,  all  baggage  of  all  immigrants  and  all  containers  of  all  such  baggage  destined  to  pass 
into  or  through  Michigan  must  be  detained  until  disinfected.”  The  exceptions  mentioned  are,  first, 
“ baggage  bearing  a certificate  issued  by  an  inspector  authorized  or  accredited  by  the  Michigan  State 
Board  of  Health;”  second,  baggage  contained  in  sealed  cars,  such  seals  not  to  be  broken  or  the  cars 
opened  in  the  State  of  Michigan;  third,  “ hand  baggage  of  immigrants  used  en  route,  and  known  to  have- 
crossed  the  ocean  in  ships  uninfected  with  any  dangerous,  communicable  disease,  or  bearing  a certificate 
of  disinfection,  issued  by  an  inspector  authorized  or  accredited  by  the  Michigan  State  Board  of  Health.” 
Under  these  rules  the  baggage  of  all  immigrants  was  subject  to  disinfection  whether  such  immigrant 
came  from  a port  or  locality  where  any  dangerous,  communicable  disease  existed  or  not.  Indeed,  there 
was  no  allegation  in  the  complaint  that  the  baggage  in  question  came  from  such  locality.  This  is 
beyond  the  power  of  the  board.  We  do  not  intimate  that  it  would  not  be  competent  for  the  legislature 
to  provide  for  the  disinfection  of  all  baggage,  where,  in  the  opinion  of  the  Board  of  Health,  from  the 
prevalence  of  a contagious  disease,  such  precaution  is  necessary.  But,  instead  of  doing  so,  it  is  provided 
by  section  three  that  the  board  is  authorized  to  establish  general  rules  and  by  an  inspector  acting  by 
virtue  thereof  to  detain  railroad  cars  or  other  public  or  private  conveyances,  etc.,  whenever  it  shall  be 
shown  to  the  satisfaction  of  such  board  or  to  the  inspector  as  provided  in  such  rules,  that  such  cars  or 
other  conveyances  contain  any  passenger,  person  or  property  which  has  been  exposed,  etc.,  or  when  it  is 
shown  to  the  satisfaction  of  such  board  or  inspector  as  aforesaid  that  such  passenger,  person  or  pro- 
perty are  being  transported  from  any  locality  where  any  such  dangerous,  communicable  disease  exists 
and  where  such  persons  or  property  are  likely  to  carry  infection  of  such  dangerous,  communicable  dis- 
ease. The  rule  in  question  did  not  make  it  a pre-requisite  to  the  inspection  that  the  baggage  being  trans- 
ported come  from  a locality  where  such  disease  existed,  as  ascertained  either  by  the  board  or  inspector, 
and  in  this  respect  was  broader  than  the  statute  and  cannot  be  sustained. 

It  follows  that  the  justice  was  right  in  refusing  to  issue  the  warrant.  We  have,  however,  gone  at 
length  into  the  consideration  of  the  provisions  of  the  statute  to  show  to  what  extent  authority  is  con- 
ferred upon  the  board,  as  the  question  involved  is  one  of  great  public  importance. 

The  judgment  will  be  affirmed. 

The  other  Justices  concurred. 

IN  THE  SUPREME  COURT. 

STATE  OF  MICHIGAN, -ss. 

Glebe’s  Office. 

I,  Charles  C.  Hopkins,  Clerk  of  the  Supreme  Court  of  the  State  of  Michigan,  do  hereby  certify  that  the 
annexed  and  foregoing  is  a true  and  correct  copy  of  the  opinion  of  the  Court  now  on  file  in  said  Court  in 
said  cause;  that  I have  compared  the  same  with  the  original,  and  that  it  is  a true  transcript  therefrom, 
and  the  whole  of  said  original. 

In  Testimony  Whebeof,  I have  hereunto  set  my  hand  and  affixed  the  seal  of  said  Supreme 
1_l.  s.  | Court,  at  Lansing,  this  first  day  of  October  A.  D.  1894. 

CHAS.  C.  HOPKINS,  Clerk . 

By  Jos.  H.  Dunnebacke,  Deputy  Clerk. 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  12,  1894. 


11 


SECRETARY’S  REPORT  OF  DANGEROUS  COMMUNICABLE  DISEASES. 

OF  WORK  DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD 
OF  HEALTH,  AND  OF  THE  CONDITION  OF  HEALTH  GEN 
ERALLY  IN  MICHIGAN  DURING  THE  QUARTER 
ENDING  SEPTEMBER  30,  1894. 

Dangerous  Communicable  Diseases. 

Tlie  number  of  reports  of  outbreaks  of  dangerous  communicable  diseases 
in  Michigan,  received  from  all  sources  and  filed,  and  the  corresponding 
number  concerning  which  action  was  taken  by  this  office,  during  the 
quarter,  are  as  follows:  for  diphtheria,  93;  for  scarlet  fever,  107;  for 
typhoid  and  typho-malarial  fever,  155;  for  measles,  21;  for  small-pox,  2; 
and  for  consumption,  42.  Total  for  the  six  diseases,  420. 

The  number  of  communications  relative  to  dangerous  communicable 
diseases,  received  and  placed  on  file  during  the  quarter,  was  1,972. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and 
demands  for  weekly  and  final  reports  on  cards,  or  in  the  form  of  the  cir- 
cular letter,  were  sent  out  during  the  quarter  to  the  number  of  1,692. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  quarter, 
were:  for  diphtheria,  61;  scarlet  fever,  91;  typhoid  and  typho-malarial 
fever,  59;  measles,  104;  small-pox,  13;  consumption,  1.  Total  for  the  six 
diseases,  329. 

During  the  quarter,  the  local  columns  of  696  newspapers,  have  been 
looked  over  for  reports  of  occurrence  of  communicable  diseases.  This  has 
resulted  in  giving  this  office  information  of  the  alleged"  occurrence  of  5 
outbreaks  of  diphtheria,  4 outbreaks  of  scarlet  fever,  7 outbreaks  of  typhoid 
and  typho-malarial  fever,  2 outbreaks  of  measles,  and  1 outbreak  of  small- 
pox. To  what  extent  the  reports  of  these  alleged  outbreaks  were  verified, 
is  shown  in  the  accompanying  table. 

TABLE  I. — Showing  the  number  of  Outbreaks  of  Diphtheria , Scarlet  fever , Typhoid 
fever,  Measles,  Small-pox  and  Consumption,  from  July  1 to  September  30, 1894,  of 
which  notice  was  received  at  the  office  of  the  Michigan  State  Board  of  Health ; the 
per  cent  of  reports,  information  concerning  which  was  received  through  the  News- 
papers; the  per  cent  of  newspaper  reports  which  were  confirmed  by  the  health  officer  ; 
the  per  cent  of  newspaper  reports  which  were  denied  by  the  health  officer ; and  the 
per  cent  relative  to  which  no  reply  was  received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources, 
July  1 to 
Sept.  30, 1894. 

Per  cent  of 
all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent  of 
newspaper  re- 
ports which 
were  con- 
firmed by  the 
health  officer. 

Per  cent  of 
newspaper  re- 
ports which 
were  denied  by 
the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  health 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria __ 

93 

5 

80 

20 

0 

Scarlet  fever . _ . _ _ 

107 

4 

25 

50 

25 

Typhoid  fever 

155 

5 

71 

29 

0 

Measles __ 

21 

9 

50 

0 

50 

Small-pox 

2 

50 

100 

0 

0 

Consumption 

42 

0 

0 

0 

0 

Averages  for  the  six  diseases 

5 

63 

26 

11 

12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Small-pox  in  Michigan  in  Third  Quarter  of  1894. 

Two  new  outbreaks  of  small-pox  were  reported  during  the  quarter.  One 
in  Clayton  township,  Genesee  county,  and  one  in  Rives  township,  Jackson 
county. 

The  outbreak  in  Clayton  township  was  reported  to  this  office  July  2. 
Two  cases  occurred,  both  of  which  recovered.  The  source  of  the  infection 
of  that  outbreak  was  not  learned.  The  health  officer  says: — “Possibly 
from  a tramp  at  Lennon.”  No  other  case  was  reported  at  Lennon  or  in 
that  locality. 

The  second  outbreak  was  reported  from  Rives  township , Jackson  county, 
September  22.  The  patient  is  a child  aged  ten  years,  whose  mother  is 
alleged  to  have  died  of  small-pox  at  Marion,  Indiana,  on  September  4, 
1894.  After  the  release  of  the  child  from  isolation,  it  came  with  its  father 
to  Rives  township,  and  is  said  to  have  been  taken  sick  with  the  disease  on 
the  way.  The  case  is  reported  as  recovering,  and  it  is  believed  that  no 
new  cases  will  occur  in  that  locality. 

The  outbreak  of  small-pox  which  began  in  Detroit  during  the  quarter 
ending  June  30,  1894,  still  continues.  During  the  quarter  for  which  this 
report  is  made,  thirty-nine  new  cases  and  eight  deaths  from  the  disease 
have  been  reported  from  that  city,  of  which  eight  new  cases  and  one  death 
are  reported  to  have  occurred  during  the  week  ending  September  29. 

Compiling,  Editing,  Proof-reading,  Printing , Etc. 

A compilation  of  reports  from  health  officers  and  clerks,  relative  to 
Scarlet  Fever  in  Michigan  in  1892,  and  the  tables  for  the  article,  have  been 
made.  The  Compilation  of  the  reports  relative  to  “Typhoid  Fever  in 
Michigan  in  1892”  has  been  commenced.  The  compilation  of  the  “ Diph- 
theria in  Michigan  in  1892”  has  been  proved,  and  the  proving  of  “ Scarlet 
Fever  in  Michigan  in  1892  ” is  well  under  way. 

Articles  for  the  Report  for  1892,  have  been  prepared  on  the  following 
subjects:  Typhoid  Fever  in  1891;  Typhus  Fever;  Consumption;  Dysen- 
tery; Membraneous  Croup;  Mumps;  Chicken-Pox;  Erysipelas;  Poisoning 
from  Canned  Fruit;  Poisoning  from  Lead  Pipe;  Poisoning  from  Tyrotox- 
icon;  Nuisances  in  Michigan  in  1891;  and  the  article  relative  to  injuries 
and  loss  of  life  and  property  from  the  use  of  kerosene  in  Michigan  in  1891 
is  nearly  ready  for  the  printer. 

The  articles  mentioned  in  the  preceding  paragraph,  with  the  exception 
of  the  one  relating  to  kerosene,  have  been  edited  and  sent  to  the  State 
Printer  for  publication  in  the  Annual  Report  of  the  Board  for  1892. 

Proof  has  been  read  on  the  larger  portion  of  the  “ First  Part  ” of  the 
Report  for  1892,  and  on  that  portion  of  the  “ Second  Part  ” following  the 
article  on  Measles.  Proof  has  also  been  read  on  the  Proceedings  of  the 
July  meeting. 

The  printing  on  the  Report  for  1892  has  been  well  advanced  and  it  is 
expected  that  the  printing  will  be  completed  by  the  first  of  November. 
It  is  hoped  that  the  Report  will  be  ready  for  distribution  some  time  during 
the  fourth  quarter  of  1894. 

Work  on  Meteorology. 

The  regular  tri-daily  meteorological  observations  have  been  continued  at 
this  station,  and  a summary  for  each  week  and  month  during  the  quarter 


ABSTRACT  OP  PROCEEDINGS,  OCTOBER  12,  1894. 


13 


has  been  made  for  use  in  this  office  in  connection  with  sickness  statistics. 
The  monthly  summary  has  been  sent  at  the  end  of  each  month  to  the 
director  of  the  Michigan  Weather  Service  and  local  forecast  official  for  his 
use;  it  is  sent  by  him  to  the  chief  of  the  United  States  Weather  Bureau 
at  Washington,  I).  C. 

Ozone  test  paper  (supply  for  three  months)  was  sent  to  each  of  seven- 
teen meteorological  observers  in  Michigan. 

Diagrams  Nos.  V.,  XIV.,  and  XV.,  to  illustrate  the  article  relating  to 
meteorology  in  Michigan  in  1892,  were  made,  the  photo-engraved  plates 
therefrom  procured,  and  the  article  for  the  annual  report  for  1893  com- 
pleted and  sent  to  the  printer. 

Nine  additional  diagrams  have  been  made  and  photo-engraved,  for  use 
in  the  annual  report  of  this  Board  for  1893. 

Compilations  on  meteorological  registers  for  1893,  except  barometer, 
are  nearly  completed. 

Meteorological  registers  for  April  to  July,  1894,  inclusive,  have  been 
received,  examined,  and  computations  made  (barometer  and  humidity 
excepted)  for  each  of  eleven  stations. 

Distribution  of  Publications,  etc. 

Copies  of  the  annual  report  for  the  year  1891,  to  the  number  of  2,700, 
were  sent  to:  Sanitary  journal  exchanges,  secretaries  of  other  state  boards 
of  health  and  state  medical  societies,  correspondents,  meteorological 
observers,  meteorological  exchanges,  members  of  state  boards  of  correc- 
tions and  charities,  superintendents  of  State  institutions,  health  officers  in 
other  states,  libraries,  health  officers  and  clerks  of  townships,  cities,  and 
villages,  and  presidents  of  villages,  and  mayors  of  cities  in  Michigan,  and 
sanitarians  in  this  and  other  states. 

The  proceedings  of  the  Holland  Sanitary  Convention  has  been  sent  to 
presidents  of  villages,  the  proceedings  of  the  Charlevoix  Convention  has 
been  sent  to  clerks  of  villages,  and  the  proceedings  of  the  Sanitary  Con- 
ventions at  Traverse  City,  Owosso,  Otsego,  a paper  by  Dr.  Baker  on  the 
“ Restriction  and  Prevention  of  Dangerous  Communicable  Diseases,”  a 
discussion  on  “The  Prevention  of  Consumption”  by  Dr.  Baker,  have  been 
sent  to  each  of  970  health  officers  of  townships  in  Michigan. 

About  400  copies  of  the  proceedings  of  the  Menominee  Convention  have 
been  sent  to  citizens,  officers  of  the  convention,  and  to  those  who  took  part 
in  the  convention. 

The  proceedings  of  the  Menominee  Convention,  the  consumption  slip, 
and  the  abstract  of  proceedings  of  the  July  13, 1894,  meeting  were  sent  to: 
Members  and  ex-members  of  this  Board,  sanitary  journal  exchanges,  secre- 
taries of  State  boards  of  health,  and  of  State  medical  societies,  meteorolog- 
ical observers  and  exchanges,  superintendents  of  State  institutions, 
libraries,  correspondents,  health  officers  in  other  States,  health  officers  of 
cities  and  villages  in  Michigan,  presidents  and  secretaries  of  preceding- 
sanitary  conventions.  The  pamphlet  proceedings  of  the  Menominee 
Convention  has  also  been  sent  to  clerks  and  mayors  of  cities  in  Michigan. 

The  announcement  of  the  Union  City  Convention  has  been  distributed 
to  the  number  of  about  1,250  copies.  The  announcement  for  the  Charlotte 
Convention  has  been  distributed  to  the  number  of  1,350  copies. 

About  the  usual  number  of  pamphlets  on  the  restriction  and  prevention 
of  the  different  dangerous  diseases  were  sent  to  the  health  officers  of 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


localities  in  which  dangerous  diseases  had  been  reported.  It  was  at  the 
same  time  requested  of  these  health  officers  that  the  pamphlets  be  dis- 
tributed to  the  neighbors  of  the  persons  sick  with  such  diseases,  and  to 
such  other  persons  as  they  would  be  likely  to  benefit. 

In  response  to  special  requests  of  sanitarians  in  this  and  other  States, 
copies  of  Annual  Reports,  proceedings  of  meetings  and  sanitary  conven- 
tions, and  pamphlets  on  the  restriction  and  prevention  of  the  dangerous 
communicable  diseases,  have  been  sent  where  it  was  thought  likely  to 
benefit  public-health  interests. 

The  usual  record  of  the  distribution  of  publications  has  been  kept. 

A list  of  the  “Names  and  Addresses  of  Health  Officers  in  Michigan  for 
the  year  1894-95”  has  been  made  and  printed  to  the  number  of  1,700 
copies,  and  distributed  to  each  health  officer  of  a township,  city  or  village, 
whose  name  had  been  returned  to  this  office.  In  any  locality  where  the 
list  showed  that  the  name  and  address  of  the  health  officer  had  not  been 
returned,  the  space  was  marked  and  sent  to  the  President  of  the  Village, 
Mayor  of  the  City,  or  Supervisor  of  the  Township,  as  the  case  may  have 
been.  This  has  resulted  in  our  receiving  the  names  of  a few  health  offi- 
cers in  addition  to  those  printed  in  the  list. 

Accessions  to  the  Library,  Card-Cataloguing , etc. 

During  the  quarter  98  books  and  pamphlets  and  820  numbers  of  jour- 
nals (weeklies,  monthlies,  and  quarterlies),  have  been  received  and  entered 
in  the  library-accession  book  of  this  Office. 

The  work  on  the  card-catalogue  of  the  library  has  been  continued. 

The  work  in  connection  with  the  financial  accounts  of  the  Office  has 
been  continued. 

Publication  of  Circular  Letter  Relative  to  Consumption. 

In  August,  a circular  letter  [No.  218.]  “Official  demand  for  special 
reports  relative  to  consumption,  under  Section  8,  Act  81,  laws  of  1873,” 
was  planned  and  printed  to  the  number  of  500  copies.  The  circular 
requests  that  the  health  officer  make  weekly  reports  on  blank  “ M,”  and 
give  any  information  he  may  possess  on  the  subject,  which  will  enable  the 
State  Board  to  have  a “ general  supervision  of  the  interests  of  the  health 
and  life  of  the  citizens  of  this  State.”  The  circular  reads  as  follows: — 

[Official  demand  for  special  reports  relative  to  consumption,  under  Section  8,  Act  81,  Laws 

of  1873.] 

OFFICE  OF  THE  SECRETARY  OF  THE  MICHIGAN  STATE  BOARD  OF  HEALTH, 


[213]  Lansing , Mich., 189 

To 


Health  Officer  of 

Mich. 

Dear  Sir: — On 189. _ I wrote  to  you  relative  to  consumption  in  your 

jurisdiction,  sending  you  blanks  for  reports  to  this  office,  and  leaflets  on  the  restriction 


ABSTRACT  OF  PROCEEDINGS,  OCTOBER  12,  1894. 


15 


and  prevention  of  that  disease,  for  distribution  among  those  likely  to  be  endangered. 
No  report  or  other  information  has  been  received  from  you  since 

Consumption  is  the  most  destructive  disease  in  Michigan  at  this  time;  it  is 
now  known  to  be  a communicable  disease,  and  it  has  been  decided  by  this  State  Board 
that  it  be  included  in  the  official  list  of  diseases  “ Dangerous  to  the  public  health,”  and 
as  such,  it  is  the  health  officer’s  duty,  under  the  law , to  take  such  action  as  will  tend  to 
restrict  the  spread  of  the  disease.  Such  action  will  be  largely  educational,  reporting 
to  and  cooperating  with  the  State  Board  of  Health,  in  its  “ campaign  of  education  ” of 
consumptives  and  their  friends  and  associates.  I trust  that  you  will  also  comply  with 
that  part  of  the  law  (Section  1,  of  Act  137,  Laws  of  1883,)  which  requires  you  to  keep  the 
“Secretary  of  the  State  Board  of  Health  constantly  informed”  respecting  cases  of 
consumption  in  your  jurisdiction. 

I earnestly  request  that  you  comply  with  the  law  and  make,  each  week,  a report  to 
this  office  (on  blank  “ M,”  copies  of  which  have  been  sent  to  you),  and  that  you  give 
any  information  which  you  may  possess  relative  to  the  subject,  which  will  assist  this- 
Board  to  perform  the  duties  enjoined  upon  it  by  law,  which  are  in  part  “ The  general 
supervision  of  the  interests  of  the  health  and  life  of  the  citizens  of  this  State.” 

Very  respectfully, 

HENRY  B.  BAKER, 

Secretary . 

Pamphlet  on  the  Restriction  and  Prevention  of  Typhoid  Fever. 

At  the  July  meeting  of  this  Board  the  pamphlet  on  “ The  Prevention  of 
Typhoid  Fever  ” was  ordered  reprinted,  and  the  new  edition  was  to  contain 
the  most  important  points  in  the  leaflet  on  “ Typhoid  and  Typho-Malarial 
Fever  ” the  publication  of  which  was  discontinued. 

Accordingly  the  pamphlet  on  “ The  Prevention  of  Typhoid  Fever”  was 
revised,  and  the  “ Eighth  amended  edition  ” has  been  printed  to  the 
number  of  ten  thousand  copies. 

Publication  of  the  Slip  Relative  to  the  Prevention  of  Consumption. 

The  slip  containing,  on  one  side  the  resolution  of  the  Board  relative  to 
reporting  cases  of  tuberculosis,  and  on  the  other  side  a short  statement  of 
methods  for  the  prevention  of  consumption,  has  been  reprinted  to  the 
number  of  five  thousand  copies.  This  was  the  second  edition  of  the  two- 
page  slip.  [A  copy  of  the  edition  in  June,  1894,  is  printed  on  pages  17-18 
of  the  “ Abstract  of  Proceedings”  “ July  13,  1894.”] 

Proceedings  of  Second  Annual  Conference  of  Michigan  Health  Officers. 

The  “copy  ” for  the  pamphlet  proceedings  of  the  Second  Annual  Con- 
ference of  Michigan  Health  Officers,  held  at  Ann  Arbor,  has  been 
prepared,  edited  and  the  copy  sent  to  the  State  Printer.  It  is  hoped  to 
soon  have  the  pamphlet  ready  for  distribution. 

Extra  Work  During  This  Quarter. 

Owing  to  the  fact  that  the  State  Board  of  Agriculture  required  the  room 
which  had  been  used  by  three  clerks  of  this  Office,  it  became  necessary,  in 
order  to  have  room  for  the  clerks,  to  remove  the  contents  of  our  store-room 


16 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


to  the  old  State-Office  building.  Owing  to  the  crowded  condition  of  the 
Office,  many  things  had  been  carried  to  the  store-room  which  could  not 
without  sorting  be  destroyed,  or  go  into  the  waste  paper.  This  sorting  has 
involved  the  use  of  considerable  time,  most  of  which  had  to  be  taken  from 
regular  office  work. 

The  summer  quarter  is  the  time  when  the  clerks  generally  want  to  take 
their  annual  vacation.  This  has  made  the  work  of  the  Secretary  consider- 
ably greater  than  it  would  otherwise  have  been. 

Sanitary  Inspections  of  Localities,  and  Advice  to  Officers  and  Citizens. 

During  the  quarter,  your  Secretary  has  been  called  upon  for  advice 
involving  the  visiting  of  a number  of  localities.  The  association  having 
control  of  Harbor  Point,  desiring  to  make  that  beautiful  summer  resort  a 
model  of  sanitary  excellence,  invited  me  to  visit  and  examine  it,  and  advise 
with  its  Board  of  Trustees  with  reference  to  the  best  plan  for  the  disposal 
of  excreta  and  waste  water.  Inasmuch  as  the  welfare  of  a considerable 
number  of  people  is  involved,  I did  so,  and  will  present  herewith  a copy  of 
my  written  report  made  to  the  Board  of  Trustees. 

Diphtheria  at  Laingsburg. 

An  outbreak  of  Diphtheria  at  Laingsburg,  Shiawassee  county,  did  not 
seem  to  be  under  the  control  of  the  local  health  authorities,  and  by  request 
of  citizens,  I visited  Laingsburg,  met  the  health  officer  and  local  board  of 
health  in  the  council  chamber,  and  conferred  with  and  advised  them  con- 
cerning the  best  measures  for  stamping  out  the  disease.  In  that  little 
village  of  less  than  one  thousand  inhabitants,  there  was  then  said  to  have 
occurred  about  forty  cases  of  diphtheria.  Since  then  the  health  officer  has 
reported  that  since  the  first  case  in  February  there  have  been  72  cases, 
including  seven  deaths.  It  has  invaded  34  families.  Oct.  11,  the  health 
officer  reports  only  once  case  remaining. 

Diphtheria  at  Portland. 

An  outbreak  of  diphtheria  in  the  village  of  Portland,  Ionia  county,  in 
which  four  deaths  occurred  in  one  week,  startled  the  health  officer  and 
others.  The  health  officer  requested  me  to  visit  the  locality,  and  the 
president  of  the  village  came  to  this  office  to  ask  for  aid  from  the  State 
Board  of  Health.  Accordingly  I went  to  Portland,  met  the  health  officer, 
local  physicians,  local  board  of  health  and  others,  and  advised  a course  of 
action  by  the  householders,  physicians,  health  officer,  local  board  of  health, 
and  prosecuting  attorney  if  necessary,  which  if  strictly  followed  will,  in 
my  judgment,  stamp  out  the  disease.  The  president  of  the  village  assured 
me  that  vigorous  action  would  be  taken  in  the  directions  which  I had 
indicated. 


Typhoid  Fever  in  Marine  City.  Analyses  of  Water-Supply. 

Dr.  Shaver,  the  city  health  officer,  has  reported  since  June  9,  ten  cases 
of  typhoid  fever  in  Marine  City.  No  deaths.  He  intimates  in  his  corre- 
spondence that  there  are  other  cases  of  which  he  has  not  been  notified. 
In  answer  to  the  question  as  to  the  supposed  cause  of  the  fever,  he  states, 
in  his  correspondence,  that  “I  have  found  in  the  water  taken  from  the 


ABSTRACT  OP  PROCEEDINGS,  OCTOBER  12,  1894. 


17 


various  hydrants  in  that  vicinity”  (where  the  disease  was)  “large  num- 
bers of  worms  resembling  earth-worms,  from  one-lialf  to  two  inches  in 
length.  There  is  certainly  something  wrong  with  our  water.”  In  another 
communication  he  says:  “During  the  last  two  or  three  years  there  has 
been  a great  number  of  cases  of  typhoid  fever  and  diphtheria  in  our  city, 
the  cause  of  which  has  not  been  determined;  I have  recommended  to  the 
board  of  health  that  there  be  made  an  analysis  of  the  drinking-water  pro- 
vided by  our  system  of  water  works;  also  of  the  water  of  Belle  river,  a 
stream  with  scarcely  any  current,  running  through  the  city  and  emptying 
into  St.  Clair  river  within  the  city  limits,  and  into  which  many  sewers 
empty  above  the  surface  of  the  water.  Our  water-supply  is  obtained  from 
St.  Clair  river  only  twenty-five  feet  from  shore,  and  above  this  point  there 
are  two  private  sewers  emptying  into  this  water,  one  of  which  is  within  300 
yards  of  the  water- works.” 

The  general  water-supply  of  the  city  being  suspected  as  the  cause  of  the 
typhoid4 fever,  and  therefore  many  lives  being,  possibly,  jeopardized,  the 
secretary  thought  best  to  have  the  water  examined,  and  accordingly  caused 
a sample  taken  from  the  same  source  as  that  drank  by  the  person  having 
the  fever  to  be  collected  and  a chemical  and  bacteriological  examination  to 
be  made  at  the  Michigan  State  Laboratory  of  Hygiene,  at  Ann  Arbor. 
Dr.  McClintock,  assistant  in  charge  of  the  laboratory  in  the  absence  of  Dr. 
Vaughan,  made  the  examinations  and  reported  in  detail  to  this  office. 
Two  samples  of  the  water  were  found  to  be  chemically  bad.  “ The  worms 
found  are  of  the  genus  Gordia,  in  one  stage,  a parasite  or  water  beetle,  etc.” 
The  microscopical  examination  showed  nematoid  worms  and  ova,  large 
vegetable  debris,  desmids,  diatoms,  infusoria,  and  bacteria.  Germs  were 
found  in  the  water,  which,  when  inoculated  in  white  rats  promptly  killed 
them.  Dr.  McClintock  gave  hi s conclusions  and  recommendations  as 
follows: — 

“This  water  is  bad  chemically  and  bacteriologically.  Still  I cannot  say 
positively  that  it  will  produce  disease,  as  the  first  ’ sample  was  so  long 
delayed  that  the  bacteriological  analysis  was  not  reliable.  The  water 
should  not  be  used  for  drinking  purposes  without  being  boiled.” 

The  result  of  this  examination  was  promptly  communicated  to  Dr. 
Shaver,  health  officer  of  Marine  City. 

The  practical  test  of  the  water  by  its  daily  use  seems  to  teach  us  that  a 
small  proportion  of  those  who  use  it  contract  typhoid  fever.  But  no  per- 
son desires  to  have  the  fever,  it  being  considered  a preventable  filth  dis- 
ease, so  the  water  should  be  boiled  before  it  is  used,  and  as  soon  as 
practicable  either  the  sewers  which  empty  into  it  should  be  removed,  or 
the  in-take  pipe  put  further  up  the  stream  and  in  a better  place. 

Work  in  Connection  with  Sickness  Statistics. 

During  the  third  quarter  of  1894,  2,090  blank  postal  report  cards,  153 
record-books  and  67  hektographed  circular  letters  regarding  weekly  card 
reports,  have  been  mailed  to  141  health  officers  and  regular  correspondents; 
1,495  weekly  card-reports  have  been  received  and  entered  on  the  register; 
50  copies  of  the  hektographed  weekly  bulletin  “Health  in  Michigan,” 
were  mailed  each  week,  and  108  copies  of  the  monthly  bulletin  “ Health  in 
Michigan”  have  been  hektographed  and  mailed  each  month.  These 
bulletins  have  been  consolidated  for  this  quarterly  report.  The  compila- 


18 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


tion  of  the  weekly  card-reports  of  sickness  during  the  year  1892,  for  the 
annual  report  for  1893  has  been  completed,  and  work  has  also  been  done  on 
the  compilation  for  the  annual  report  for  1894. 

Health  in  Michigan  in  the  Third  Quarter  of  1894.  Communicable  Diseases. 

Compared  with  the  preceding  quarter  (April,  May  and  June),  reports 
from  all  sources  show  typhoid  fever  to  have  increased  by  an  average  of 
forty-nine  places,  consumption  to  have  increased  by  an  average  of  thirteen 
places,  measles  to  have  decreased  by  an  average  of  seventy -three  places, 
scarlet  fever  to  have  decreased  by  an  average  of  twenty-eight  places,  diph- 
theria to  have  decreased  by  an  average  of  twelve  places  and  ‘small-pox  to 
have  decreased  by  an  average  of  three  places. 

Meteorology  at  one  Central  Station,  and  Sickness  throughout  Michigan  from  all 
causes,  Third  Quarter  of  1894,  compared  with  the  Preceding  Quartet. 

A comparison  of  meteorological  conditions  of  the  third  quarter  of  1894, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
prevailing  direction  of  the  wind  to  have  been  south-west  (instead  of  north- 
west), the  average  velocity  1.2  miles  per  hour  less,  the  temperature  10.21 
degress  higher,  the  rainfall  2.48  inches  less,  the  absolute  humidity  con- 
siderably more,  the  relative  humidity  less,  the  day  ozone  slightly  less,  the 
night  ozone  much  less  and  the  depth  of  water  in  the  well  at  Lansing 
4 inches  less  in  the  third  quarter  of  1894. 

Compared  with  the  preceding  quarter  (April,  May  and  June),  the 
reports  from  regular  observers  show  a marked  increase  of  dysentery, 
typhoid  fever,  diarrhea  and  remittent  fever,  and  a marked  decrease  of 
measles,  pneumonia,  influenza,  pleuritis,  erysipelas,  inflammation  of 
kidney,  tonsillitis,  scarlet  fever  and  bronchitis  in  the  third  quarter  of 
1894. 

The  Weather  and  the  Health  in  Michigan  in  the  Third  Quarter  of  1894,  Compared 
with  the  Average  for  the  Eight  Years , 1886-1893. 

A comparison  of  the  meteorological  conditions  of  the  third  quarter  of 
1894,  with  the  average  for  the  third  quarters  in  the  eight  years,  1886-1893, 
shows  that  in  1894,  the  prevailing  direction  of  the  wind  was  the  same 
(south-west),  the  velocity  was  0.7  of  a mile  per  hour  greater,  the  tempera- 
ture was  1.97  degrees  higher,  the  rainfall  was  1.04  inches  less,  the  absolute 
humidity  was  slightly  less,  the  relative  humidity  was  much  less,  the  day 
and  night  ozone  were  slightly  more  and  the  depth  of  water  in  the  well  at 
Lansing  was  2 inches  less. 

Compared  with  the  average  in  the  corresponding  quarters  in  the  eight 
years  1886-1893,  the  reports  from  regular  observers  indicate  that  typhoid 
fever  was  more  than  usually  prevalent,  and  that  erysipelas,  intermittent 
fever  and  remittent  fever  were  less  than  usually  prevalent  in  the  third 
quarter  of  1894. 


ABSTRACT  OF  PROCEEDINGS 


OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


REGULAR  MEETING,  JANUARY  11,  1895. 


219.] 

The  Michigan  State  Board  of  Health  held  its  regular  quarterly  meeting, 
it  the  office  of  the  Secretary,  in  the  Capitol  at  Lansing,  January 
LI,  1895.  The  meeting  was  called  to  order  by  the  President.  Hon.  Frank 
Veils,  President,  of  Lansing;  Prof.  Delos  Fall,  of  Albion;  Prof.  V.  C. 
Vaughan,  of  Ann  Arbor;  Mason  W.  Gray,  M.  D.,  of  Pontiac;  Samuel  G. 
Milner,  M.  D.,  of  Grand  Rapids;  George  H.  Granger,  M.  D.,  of  Bay  City; 
md  Henry  B.  Baker,  M.  D.,  Secretary,  were  present.  The  regular  busi- 
less,  including  the  auditing  of  bills  and  accounts,  was  transacted. 

Should  the  State  Board  of  Health  undertake  to  supply  Antitoxine? 

' As  special  committee  to  report  to  the  board  the  advisability  of  entering 
lpon  the  production  of  immunizing-blood-serum  (antitoxine)  for  use  in 
;he  production  of  immunity  from  diphtheria,  with  a view  of  still  further 
lesting,  in  this  country,  the  efficacy  of  the  method,  Doctor  Vaughan, 
Director  of  the  Michigan  State  Laboratory  of  Hygiene,  reported  that  he 
lad  thoroughly  considered  the  subject,  and  had  concluded  that  at  the  pres- 
ent time,  the  expense  would  be  too  great  for  the  State  Board  of  Health  to 
mdertake. 

Doctor  Baker  also,  suggested  that  such  action  by  this  Board  would  not 
le  in  accord  with  its  former  action.  It  would  be  in  the  line  of  treatment, 
vhich  this  Board  has  heretofore  been  very  careful  to  avoid.  He  said  that 
f any  line  of  treatment  were  to  be  commended  by  the  State  Board  of 
Sealth,  he  would  suggest  that  devised  by  Dr.  Loeffler,  the  German  physi- 
cian who  discovered  the  bacillus  now  recognized  as  the  specific  cause  . of 
liphtheria.  He  read  a letter  which  he  had  received  from  Erwin  F.  Smith, 
)f  Washington,  D.  C.,  a former  employe  of  this  office,  relative  to  the  new 
;reatment  of  diphtheria  recommended  by  Dr.  Loeffler.  In  artificial  cultures, 
Dr.  Loeffier’s  solution  kills  the  bacillus  of  diphtheria  in  five  seconds.* 
Dr.  Baker  suggested  that  if  the  local  treatment  which  Doctor  Loeffler 


♦Since  the  meeting,  it  has  been  learned  that  “ Loeffler’s  Solution  ” is  prepared  and  sold  by  manufactur- 
ng  chemists  of  Detroit. 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


recommends,  kills  the  germ  before  it  has  had  opportunity  to  produce  it 
toxine,  there  would  be  less  use  for  the  antitoxine.  But  it  would  be  mon 
appropriate  for  this  Board  to  continue  along  the  line  in  which  it  has  beei 
working,  for  the  restriction  of  diphtheria,  through  isolation  and  disinfec 
tion.  He  pointed  out  the  fact  that  in  all  localities  in  Michigan  in  whicl 
the  measures  recommended  by  the  State  Board  of  Health  are  full’ 
accepted  and  enforced,  in  each  outbreak,  an  average  of  only  .48  of  on 
death  occurs  from  diphtheria.  (This  is  shown  by  the  right-hand  columi 
in  the  diagram  printed  herewith,  page  8.)  This  is  in  localities  into  whic. 
the  disease  has  been  introduced.  This  being  an  established  fact,  it  seem 
a little  like  “refining  pure  gold”  for  the  Board  to  go  back  to  any  metho< 
of  treatment.  If,  however,  it  is  claimed  that  even  this  small  residue  of  .4 
of  one  death  per  outbreak  should  be  reduced,  he  would  claim  that  i 
should  be  done  by  a continuance  of  the  principle  of  prevention.  H 
thought  it  more  important  than  any  mode  of  treatment  of  diphtheria  tha 
there  should  be  a State  law  which  would  prevent  the  introduction  of 
dangerous  disease  into  a locality.  There  is  no  general  law  in  Michigai 
under  which  punishment  can  be  inflicted  for  conveying  diphtheria  or  an; 
dangerous  disease  from  place  to  place;  and  every  year  our  reports  sho\ 
that  this  is  done,  in  numerous  instances.  The  present  law  is  not  operat 
ive  until  after  the  local  board  of  health  has  made  and  published  regulations 
He  had  several  times  drawn  a bill  to  remedy  this  defect,  but  the  legislatur 
has  never  yet  passed  one. 

Examination  of  Samples  of  Antitoxine  offered  for  sale  in  Michigan 

It  was  suggested  that  the  Board  take  action  to  protect  the  people  agains 
spurious  antitoxines.  On  motion  of  Dr.  Granger,  the  Board  voted  t 
appoint  Prof.  Victor  C.  Vaughan,  M.  D.,  Director  of  the  Michigan  Stat 
Laboratory  of  Hygiene,  a special  committee  to  test  the  immunizing  proper 
ties  of  samples  of  antitoxine  offered  for  sale  in  Michigan. 

An  Improved  Law  for  Registration  of  Births  and  Deaths. 

Dr.  Baker  offered  the  following  preambles  and  resolutions,  which  wer 
unanimously  adopted: 

Whereas,  An  accurate  and  prompt  registration  of  the  deaths  and  th 
causes  of  deaths  in  each  locality  of  this  State  would  be  of  very  great  prac 
tical  usefulness  to  the  work  of  this  Board,  and  consequently  of  great  vain 
to  the  people  of  Michigan,  and  . 

Whereas,  Under  the  present  law,  which  has  not  been  amended  sine 
1869,  the  registration  of  vital  statistics  has  failed  to  give  accurate  results 
and  to  present  them  sufficiently  early  to  be  of  the  greatest  practical  sani 
tary  use  and  public  interest;  therefore 

Resolved , That  the  Michigan  State  Board  of  Health  earnestly  recom 
mends  the  enactment  of  an  improved  law  for  the  registration  and  retur: 
of  deaths  (and  also  of  births),  which  law  shall  provide  for  their  immediat 
record,  and  prompt  report  to  the  State  Department. 

Resolved,  That  a committee  be  appointed  by  this  Board  to  present  th 
subject  to  the  Legislature,  and  to  urge  such  action;  said  committee  to  ac 
independently  or  in  conjunction  with  similar  committees  of  the  Michiga. 
State  Medical  Society,  Michigan  Academy  of  Science,  or  other  organiza 
tions,  as  may  be  deemed  advisable. 


, memGkU  STATE  BOARD  OF  HEALTjK  EXHIBIT./ 

OLATION  AND  DISINFECTION  RESTRICTED 
ARLET  FEVER  AND  DIPHTHERIA  IN  MICHI- 
N DURING  THE  5 YEARS  1886-90. 


SCARLET  FEVER. 


SOLATION  AND 


1EGLECTED.IN 
!66  OUTBREAKS, 


DISINFECTION 


ENFORCED.  IN 


361  OUTBREAKS, 


DIPHTHERIA. 

ISOLATION  AND  DISINFECTION 
NECLECTER  ^ENFORCED,  IN 


317  OUTBREAKS 


252  OUTBREAKS, 


2.04 


v AVERAGE 


JASES  DEATHS. 


CASES, 


AVERAGE*- 


DEATHS 


AVERAGE 


CASES.  DEATHS 


AVERAGE 


'OTALS i OUTBREAK  S,I,857*;CA$ES,II,3I2;DEATHS,$9I 

V • 

IIC ATE  D SAVINC  OF  CASES  13.29  X 1,857  • I r.3 1 2 = I3,3b*8 


T0TALS>0UTBREAKS.I.9  8S!CASES.II,6  31)DEATHS,2,S7e 
INDICATED  SAVINC  OF  CASES  13.57  X 1.9 85 • 1 1,6 3 4: 15,3 02 


IDICATED  SAVINC  OF  LIVES  .69  X 1.857  • 591  = 690 

UU*  (trinru*,  net  flrrriy  V/ym  ltd'  tf  'Lnjeretd 


INDICATED  SAVINC  OF  LIVES  2.67  X 1.9  85-2,5  7 0 = 2.7  22 

•: --v  J 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


The  subject  was  referred  to  the  Committee  on  “Statistics  of  Mortalitj 
and  Sickness,”  with  request  to  act  in  accordance  with  the  resolutions. 

Poisoning  by  Dried  Beef  at  Somerset  Center , Hillsdale  Co. 

Doctor  Vaughan,  the  committee  to  whom  was  referred  the  subject  o 
suspected  poisoning  by  dried  beef,  at  Somerset  Center,  Hillsdale  county 
reported:  “We  find  that  the  meat  contains  a short  bacillus  whieh,  whei 
injected  under  the  skin  of  rats,  guinea  pigs  and  rabbits,  causes  deatl 
within  from  24  to  48  hours.  The  bacillus  causes  marked  local  irritation 
and  there  can  be  no  doubt  that  it  was  the  active  agent  in  causing  the  dis 
tress  in  the  persons  who  ate  of  the  meat.  A careful  biological  study  o 
this  germ  will  be  made,  and  a further  report  will  be  sent  you  at  a late 
date.” 

Suspected  Poisoning  by  Pressed  Chicken  at  Sturgis. 

Doctor  Vaughan  also  reported  relative  to  suspected  poisoning  by  presses 
chicken  at  Sturgis.  During  a banquet  some  200  persons  were  poisonec 
A sample  of  the  chicken  was  examined  at  the  State  Laboratory  of  Hygiene 
and  found  to  contain  a short  capsulated  bacillus  which  was  poisonous,  bu 
not  of  such  a virulent  character  as  the  one  found  in  the  dried  beef.  It  wa 
found,  by  inoculation,  that  the  germ  would  kill  guinea  pigs,  but  did  no 
kill  rats. 

A Bill  to  Regulate  Employment  of  Consumptive  Nurses  and  Teachers 

Doctor  Milner  of  Grand  Rapids,  Committee  on  Schools,  was  directed  t 
prepare  a bill,  for  introduction  in  the  Legislature,  which  shall  regulate  th 
employment  of  teachers  in  our  public  schools,  and  professional  nurse* 
who  are  affected  with  any  communicable  form  of  tuberculosis.  Instance 
have  been  noted  and  referred  to  by  Dr.  Milner  at  a previous  meeting 
where  it  is  probable  that  tuberculosis  (consumption)  has  been  contracte 
from  a teacher. 

Proposed  Improvement  of  Sanitary  Lazos  relative  to  Live  Stock. 

On  motion,  the  Board  voted  to  direct  the  Committee  on  Legislator 
Doctor  Granger  of  Bay  City,  to  confer  with  members  of  the  State  Liv 
Stock  Commission  and  the  State  Veterinarian,  to  prepare  bills  for  th 
improvement  of  the  sanitary  laws  of  the  State  relative  to  live  stock,  rek 
tive  to  diseases  communicable  to  man,  and  to  look  to  the  introduction  an 
passage  of  such  bills. 

A proposed  State  Hospital  for  Consumptives. 

The  proposed  bill  for  a “ State  Hospital  for  Consumptives,”  in  Conner 
tion  with  the  State  Laboratory  of  Hygiene  at  the  University,  was  rea 
section  by  section,  amended  and  approved  by  the  Board.  The  objects  c 
the  hospital  are:  (1)  the  proper  care  and  treatment  of  persons  havin 
the  disease  known  as  consumption,  phthisis  or  tuberculosis,  in  order  th? 
the  spread  of  this  disease  may  be  lessened;  (2)  the  training  and  educatio 
of  persons  who  shall  go  out  from  that  hospital,  in  the  best  methods  fc 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  11,  1895. 


5 


•estricting  the  spread  of  this  dangerous  disease;  (3)  the  training  in  such 
nethods,  of  medical  students  who  are  to  practice  medicine  in  Michigan,  so 
hat  they  may  know  how  to  restrict  tuberculous  diseases;  and  (4)  that 
ffiysicians  and  others  may  be  enabled  to  study  this  disease  under  favorable 
conditions,  thereby  obtaining  knowledge  useful  for  the  prevention  of  the 
ipread  of  this  disease,  and  for  its  ultimate  restriction  or  extinction  in 
Michigan. 

Proposed  Enforcement  of  Public  TLealth  Laws  in  localities  ichere 

Local  Officers  fail  to  act. 

By  invitation  of  the  Governor,  the  Board  met  the  Governor  in  his  room 
or  conference  relative  to  the  work  of  the  Board,  and  a proposed  increase 
n its  scope,  one  question  being  whether  the  public  interests  might  be  bet- 
er  subserved  if  the  Board  were  given  power  to  stamp  out  dangerous  dis- 
eases in  localities  where  for  any  reason  the  local  officers  were  unable  or 
mwilling  to  take  proper  measures. 


;ECRETARY’S  report  of  dangerous  communicable  diseases, 

' OF  WORK  DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD 
OF  HEALTH,  AND  OF  THE  CONDITION  OF  HEALTH  GEN- 
ERALLY IN  MICHIGAN  DURING  THE  QUARTER 
ENDING  DECEMBER  31,  1891. 

Dangerous  Communicable  Diseases. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  diseases 
n Michigan,  received  from  all  sources  and  filed,  and  the  corresponding 
lumber  concerning  which  action  was  taken  by  this  office,  during  the 
[uarter,  are  as  follows:  for  diphtheria,  155;  for  scarlet  fever,  189;  for 
yphoid  and  typho-malarial  fever,  176;  for  measles,  16;  for  small-pox,  21; 
nd  for  consumption,  8.  Total  for  the  six  diseases,  565. 

The  number  of  communications  relative  to  dangerous  communicable 
liseases,  received  and  placed  on  file  during  the  quarter,  was  2,482. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and 
lemands  for  weekly  and  final  reports  on  cards,  or  in  the  form  of  the  cir- 
ular  letter,  were  sent  out  during  the  quarter  to  the  number  of  2,012. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  quarter, 
tere:  for  diphtheria,  96;  scarlet  fever,  100;  typhoid  and  typho-malarial 
ever,  143;  measles,  2;  small-pox,  13;  consumption,  0.  Total  for  the  six 
iseases,  347. 

During  the  quarter,  the  local  columns  of  800  newspapers,  have  been 
Doked  over  for  reports  of  occurrence  of  communicable  diseases.  ( This  work 
3 done  by  the  clerk  who  acts  as  messenger  and  janitor,  in  the  intervals  of 
is  performance  of  other  duties.)  This  has  resulted  in  giving  this  office 
uformation  of  the  alleged  occurrence  of  6 outbreaks  of  diphtheria,  3 out- 
breaks of  scarlet  fever,  17  outbreaks  of  typhoid  and  typho-malarial  fever, 
outbreak  of  measles,  and  3 outbreaks  of  small-pox.  To  what  extent  the 
eports  of  these  alleged  outbreaks  were  verified,  is  shown  in  the  accom- 
•anying  table. 


6 MICHIGAN  STATE  BOARD  OP  HEALTH. 


TABLE  I. — Showing  the  number  of  Outbreaks  of  Diphtheria , Scarlet  fever,  Typhoid 
fever,  Measles,  Small-pox  and  Consumption,  from  October  1 to  December  31,  1894,  of 
which  notice  was  received  at  the  office  of  the  Michigan  State  Board  of  Health;  the 
per  cent  of  reports,  information  concerning  which  was  received  through  the  News- 
papers ; the  per  cent  of  newspaper  reports  which  were  confirmed  by  the  health  officer ; 
the  per  cent  of  newspaper  reports  which  were  denied  by  the  health  officer;  and  the 
per  cent  relative  to  which  no  reply  was  received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources, 
Oct.  1 to 
Dec.  31,  1894. 

Per  cent 
of  all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent 
of  newspaper 
reports  which 
were  con- 
firmed by  the 
health  officer. 

Per  cent 
of  newspaper 
reports  which 
were  denied 
by  the 

health  officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  health 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria 

155 

4 

67 

0 

33 

Scarlet  fever. 

189 

2 

100 

0 

0 

Typhoid  fever 

176 

10 

47 

12 

41 

Measles 

16 

6 

0 

0 

0 

Small-pox 

21 

14 

100 

0 

0 

Consumption 

8 

0 

0 

0 

0 

Averages  for  the  six  diseases 



5 

60 

6 

33 

Small-pox  in  Michigan  in  the  fourth  quarter  of  1894. 

Eleven  new  outbreaks  were  reported  during  the  quarter.  These  occur- 
red in  Manchester  township,  Washtenaw  Co.;  Norvell  township,  Jacksor 
Co.;  Cheboygan  city;  St.  Johns  village,  Clinton  Co. ; Royal  Oak  township, 
Oakland  Co.;  Sebewa  township,  Ionia  Co.;  Danby  township,  Ionia  Co.; 
Adrian  city;  Watersmeet  township,  Gogebic  Co.;  Chester  township,  Eator 
Co.;  and  Marquette  city.  Of  these  outbreaks,  final  reports  of  those  at  Nor- 
vell township,  Cheboygan  and  Adrian,  have  been  received.  It  is  inferred 
that  those  at  Manchester  township,  Chester  township  and  Danby  township 
are  over,  but  no  final  reports  of  these  three  outbreaks  have  yet  reached 
this  office  at  this  date — Jan.  1,  1895. 

Small-pox  is  still  present  at  Marquette,  Detroit,  St.  Johns,  Sebewa  town- 
ship, Royal  Oak  township,  Watersmeet  township. 

The  outbreak  which  began  in  Detroit  during  the  second  quarter  of  1894 
still  continues.  During  the  quarter  just  closed,  there  have  occurred  ir 
that  city,  72  cases  and  21  deaths,  which  make  a total  of  142  ca^es  and  34 
deaths  since  the  outbreak  began.  From  the  beginning  of  the  outbreak  ir 
Detroit,  (about  May  25,  1894,)  up  to  the  first  week  of  October,  there 
occurred  70  cases  and  13  deaths,  which  is  a death  rate  of  19  per  cent 
During  the  quarter  ending  Dec.  31,  1894,  there  have  occurred  72  cases  anc 
21  deaths,  a death  rate  of  29  per  cent  during  the  last  half  and  coolei 
months  during  which  the  outbreak  has  existed. 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  11,  1895.  7 

|1' 

In  the  thirty-eight  outbreaks  of  small-pox  reported  during  the  year  1894, 
Deluding  Detroit,  there  have  occurred  262  cases  and  60  deaths,  a death 
•ate  of  23  per  cent.  The  death  rate  for  the  city  of  Detroit  and  for  locali- 
ties outside  of  that  city,  have  been  nearly  the  same, — Detroit  a little  less 
:han  24  per  cent,  and  outside  localities,  a fraction  less  than  22  per  cent. 

In  twenty-one  of  the  twenty-nine  outbreaks  now  over,  the  infection  was 
restricted  to  the  one  house  in  which  it  first  occurred. 

Summary  Relative  to  the  Year , 1894. 

During  the  year  1894,  this  office  took  action  upon  2,036  outbreaks  of 
dangerous  communicable  diseases,  which  number  includes  469  outbreaks 
i)f  diphtheria,  656  outbreaks  of  scarlet  fever,  447  outbreaks  of  typhoid 
ind  typho-malarial  fever,  275  outbreaks  of  measles,  16  outbreaks  of  small- 
pox, and  128  outbreaks  of  consumption.f 


TABLE  II, — Showing  the  number  of  Outbreaks  of  Diphtheria , Scarlet  Fever , Typhoid 
Fever  and  Measles,  from  January  1 to  December  31,  1894,  of  which  notice  was 
received  at  the  office  of  the  Michigan  State  Board  of  Health ; the  per  cent  of  reports, 
information  concerning  which  was  received  through  the  Newspapers ; the  per  cent 
of  newspaper  reports  which  were  confirmed  by  the  health  officer;  the  per  cent  of 
newspaper  reports  which  were  denied  by  the  health  officer,  and  the  per  cent  relative 
to  which  no  reply  was  received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources. 
Jan.  1-Dec. 
31,  1894. 

Per  cent 
of  all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent 
of  newspaper 
reports  which 
were  con- 
firmed by  the 
health  officer. 

Per  cent 
of  newspaper 
reports  which 
were  denied 
by  the 

health  officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  health 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria 

*469 

4 

50 

22 

28 

Scarlet  fever 

*656 

4 

57 

9 

35 

Typhoid  fever 

*447 

7 

48 

23 

29 

Measles 

*275 

6 

33 

13 

53 

Small-pox 

*61 

20 

50 

50 

0 

Consumpticfnt 

*128 

0 

0 

0 

0 

Averages  for  the  six  diseases 

5 

48 

21 

80 

* The  numbers  of  outbreaks  given  in  this  table  do  not  necessarily  agree  with  the  numbers  given  in  tables 
in  another  part  of  the  Annual  Report,  for  the  reason  that  all  alleged  outbreaks,  of  which  information 
was  obtained  from  the  newspapers  and  other  sources  are  included  in  this  table.  If  the  health  officers 
denied  that  such  outbreaks  occurred,  or  if  they  make  no  response  to  the  letters  sent  from  this  office, 
relative  to  newspaper  reports,  such  alleged  outbreaks  are  not  included  in  the  compilation  of  that  disease, 
t Consumption  for  the  last  nine  months  of  the  year  only. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  etc., 
were  sent  out  during  the  year  to  the  number  of  7,135.  The  number  of 
communications  relative  to  such  diseases,  which  were  received  and  placed 
on  file  during  the  year  was  8,418. 


8 


MICHIGAN  STATE  BOARD  OP  HEALTH. 


A record  is  kept  of  facts  concerning  every  outbreak  of  a “disease  dan- 
gerous to  the  public  health,”  upon  which,  action  is  taken  by  this  office, 
and  also  of  every  communication  relating  thereto  received  or  sent  out 
This  required  oyer  15,500  entries  to  be  made  in  the  “ Record  Books,”  one 
of  which  books  is  kept  for  each  dangerous  communicable  disease. 

During  the  year  1894  compared  with  the  year  1893,  action  was  taken  on 
outbreaks  of  dangerous  communicable  diseases  as  follows:  On  diphtheria, 
71  outbreaks  less,  scarlet  fever,  18  outbreaks  less;  on  typhoid  and  typho- 
malarial  fever,  53  outbreaks  more;  measles,  4 outbreaks  more;  and  small- 
pox, 59  outbreaks  more  than  in  1893.  In  all  155  outbreaks  more  were 
acted  upon  in  1894  than  in  1893,  and  363  outbreaks  more  in  1894  than  in 
1 892 , 

Compiling , Editing , Proof-Reading , Printing , etc. 

The  articles  relating  to  injuries  and  loss  of  life  and  property  in  Michi- 
gan in  1891,  from  the  use  of  kerosene,  gasoline,  naphtha,  etc.,  have  been 
completed. 

The  article  relative  to  nuisances  in  Michigan  in  1892,  has  been  nearly 
completed. 

The  article  relating  to  diphtheria  in  Michigan  in  1892  has  been  com- 
pleted ready  for  the  printer. 

A compilation  of  reports  from  all  sources  relative  to  typhoid  fever  in 
Michigan  in  1892,  has  been  made,  and  a similar  compilation  relative  to 
measles  in  Michigan,  for  the  same  year,  has  been  about  half  completed. 

The  compilation  of  reports  from  all  sources,  relative  to  scarlet  fever  in 
Michigan  during  the  year  1892,  has  been  proved  and  some  of  the  tables 
based  thereon  have  been  made. 

Those  portions  of  the  annual  reports  from  health  officers  and  clerks  of 
townships,  cities  and  villages  for  the  year  1893,  which  relate  to  diphtheria 
have  been  compiled,  and  a compilation  of  such  parts  of  those  reports  as 
relate  to  scarlet  fever  is  well  advanced. 

Copy  has  been  prepared  for  the  pamphlet  proceedings  of  the  Sanitary 
Convention  held  under  the  auspices  of  the  State  Board  of  Health  at  Union 
City,  Oct.  25  and  26,  1894,  and  a portion  of  the  copy  has  been  sent  to  the 
printer. 

The  copy  for  the  proceedings  of  the  Charlotte  Sanitary  Convention  is 
now  nearly  ready  for  the  printer. 

Copy  on  the  proceedings  of  the  Second  Annual  Conference  of  Health 
Officers,  at  Ann  Arbor,  J une,  1894,  has  been  prepared  and  the  proceedings 
printed  in  pamphlet  form. 

The  index  for  the  Annual  Report  of  this  Board  for  the  fiscal  year  end- 
ing J une  30,  1892,  has  been  made  and  printed. 

Proof  has  been  read  on  the  following:  Proceedings  of  the  Second 
Annual  Conference  of  Health  Officers;  Proceedings  of  the  Meeting,  Oct. 
12;  and  articles  for  the  Annual  Report  for  1892  relating  to  the  following 
subjects:  Membraneous  Croup,  Chicken-pox,  Erysipelas,  Leprosy,  Hydro- 
phobia. Glanders,  Tyrotoxicon  Poisoning,  Poisoning  from  Canned  Cur- 
rants, Poisoning  by  Lead  Pipe,  Suspected  Coffee  Poisoning,  Alleged 
Nuisances,  Injuries  and  Loss  of  Life  and  Property  from  Kerosene,  Gaso- 
line and  Naphtha;  and  also  on  the  index  for  the  Annual  Report  for  the 
year  1892. 

That  portion  of  the  Report  for  the  Fiscal  year  ending  June  30,  1892, 
relative  to  the  above-mentioned  articles  (including  the  Index)  has  been 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  11,  1895. 


9 


printed,  and  the  Eeport  is  now  being  bound  by  the  State  Printer.  Copies 
will  be  ready  for  distribution  by  the  middle  of  January. 

Hektograph  work  to  the  number  of  1,650  pages  has  been  made,  of  which 
about  350  pages  were  relative  to  the  Small-pox  situation  in  Michigan  since 
January  1,  1894,  being  in  the  form  of  tabular  statements.  Only  35  pages 
have  been  notifications  relative  to  possibly  infected  immigrants. 

A diagram  “Ages  of  persons,  5 to  80  years,  who  died  from  diphtheria  in 
Massachusetts  during  the  period  22  years,  1863-84”  was  hektographed  to 
the  number  of  41  copies.  A diagram  similar  to  the  foregoing,  but  for 
Michigan  for  21  years,  1872-92,  was  hektographed  to  the  number  of  37 
copies. 

Work  on  Meteorology. 

The  regular  tri-daily  meteorological  observations  have  been  continued  at. 
this  station,  and  a summary  for  each  week  and  month  during  the  quarter 
has  been  made,  for  immediate  use  in  this  office  in  the  weekly  and  monthly 
bulletins  relating  to  sickness  statistics.  The  monthly  summary  has  been 
sent,  at  the  end  of  each  month,  to  the  Director  of  the  Michigan  Weather 
Service  and  Local  Forecast  Official  at  Detroit  for  his  use,  and  it  is  sent  by 
him  to  the  Chief  of  the  U.  S.  Weather  Bureau  at  Washington,  D.  C. 

Meterological  blank  registers,  envelopes,  postal  cards,  ozone  test-paper, 
etc.,  were  sent  to  observers  for  the  State  Board  of  Health  on  Dec.  15,  for 
their  use  in  1895. 

The  article  relating  to  Meteorology  in  Michigan  in  1892  has  been  sent 
to  the  State  Printer,  and  two  forms  have  been  printed,  for  the  Annual 
Eeport  for  1893. 

Distribution  of  Publications , etc. 

About  600  copies  of  the  Proceedings  of  the  last  regular  meeting,  (Oct. 
12,  1894)  have  been  distributed  to:  Members  and  Ex-members  of  this 
Board,  Sanitary  Journal  Exchanges,  Meteorological  Observers,  members 
of  the  State  Board  of  Corrections  and  Charities,  Secretaries  of  State  Boards 
of  Health,  Health  Officers  of  cities  and  villages  in  Michigan,  Judges  of 
The  Supreme  Court,  and  Sanitarians. 

About  1,300  copies  of  the  Programs  of  the  Union  City  Sanitary  Con- 
vention, and  about  1,300  copies  of  the  Program  for  the  Charlotte  Sanitary 
Convention  have  been  distributed,  from  this  Office. 

During  the  quarter  1,573  envelopes  were  directed  to  health  officers  of 
townships,  cities  and  villages,  and  about  the  same  number  (1,572)  of 
envelopes  were  directed  to  clerks  of  townships,  cities  and  villages.  These 
envelopes  were  used  in  sending  to  each  clerk  and  health  officer  in  Mich- 
igan blank  forms  for  making  annual  reports  of  “Diseases  dangerous  to  the 
public  health”  during  the  year  1894,  a circular  letter  giving  instructions 
for  making  out  the  annual  reports,  and  an  envelope  for  the  return  of  the 
report  to  this  office.  This  material  was  mailed  from  this  Office  Dec.  29 
and  31,  1894. 

About  the  usual  numbers  of  pamphlets  on  the  restriction  and  prevention 
of  the  different  dangerous  diseases  were  sent  to  the  health  officers  of  local- 
ities in  which  dangerous  diseases  have  been  reported.  It  was  at  the  same 
„time  requested  of  these  health  officers  that  the  pamphlets  be  distributed 
to  the  neighbors  of  the  persons  sick  with  such  diseases , and  to  such  other 
persons  as  they  would  be  likely  to  benefit.  In  response  to  special  requests 
of  sanitarians  in  this  and  other  States,  copies  of  annnal  reports,  proceed- 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


mgs  of  Sanitary  Conventions,  proceedings  of  meetings,  and  pamphlets  or 
the  restriction  and  prevention  of  the  dangerous  communicable  diseases 
have  been  sent  where  it  was  thought  likely  to  benefit  public-health 
interests. 

The  usual  record  of  distribution  of  publications  has  been  kept. 

Accessions  to  the  Library , Card- Cataloguing,  etc. 

One  hundred  and  eighteen  books  and  pamphlets,  and  some  325  numbers 
of  journals  (weeklies,  monthlies,  quarterlies)  have  been  received  and 
entered  in  the  library-accession  book  of  this  Office. 

Work  on  the  card- catalogue  of  the  library  has  been  continued. 

The  work  in  connection  with  the  financial  accounts  of  the  Office  hat 
been  continued. 

The  Michigan  Plan  for  the  Restriction  of  Consumption. 

Your  Secretary  has  recently  received  a letter  from  Dr.  H.  B.  Horlbeck, 
who  for  many  years  has  been  the  efficient  Health  Officer  of  Charleston. 
S.  C.,  a prominent  member  of  the  American  Public  Health  Association, 
and  a prominent  sanitarian  in  this  country,  in  which  the  hope  is  expressed 
that  Charleston  may  follow  the  “ good  example  set  by  the  State  of  Michi- 
gan in  attacking  consumption  or  tuberculosis.”  In  accordance  with  Dr. 
Horlbeck’s  request,  Secretary  Baker  sent  him  such  pamphlets,  leaflets, 
copies  of  laws  under  which  the  work  is  being  done  in  Michigan,  and  dia- 
grams showing  the  result  of  a similar  work  which  has  been  so  successful 
in  Michigan  in  lessening  the  number  of  deaths  from  scarlet  fever.  The 
information  given  Dr.  Horlbeck  related  to  Michigan’s  plan  for  the  legal 
control  of  tuberculosis,  and  more  especially  for  the  restriction  of  the  dis- 
ease through  the  systematic  and  continuous  education  of  the  people  most 
endangered — the  relatives,  friends  and  associates  of  consumptives. 

Medical  Attendance  on  an  Indigent  Person  is  a Charge  upon  the  County. 

About  December  14  the  Secretary  received  a letter  from  a health  officer 
of  a township,  who  had  been  called  as  a physician  to  treat  a case  of  typhoid 
fever  in  a township  of  another  county.  He  had  presented  his  bill  to  the 
health  officer  of  that  township,  the  health  officer  had  certified  to  its  cor- 
rectness; and  the  bill  was  presented  to  the  board  of  supervisors.  The  orig- 
inal amount  of  the  bill  was  $33.00,  and  the  board  of  supervisors  cut  the 
bill  to  $19.00.  The  attending  physician  had  been  obliged  to  go  a long  dis- 
tance, and  had  not  at  any  time  charged  to  exceed  $2.00  per  visit.  The 
reduction  in  the  bill  therefore  seemed  to  be  unreasonable.  The  Secretary’s 
reply  was  substantially  as  follows: 

STATE  BOARD  OF  HEALTH,  ) 
Office  of  the  Secretary,  y 
Lansing,  Michigan,  Dec.  14,  1894.  ) 

Dear  Doctor — Replying  to  your  letter  of  Dec.  12,  it  would  seem  from  the  facts 

before  me  that  your  bill  was  extremely  reasonable,  in  the  case  of , Michigan, 

and  should  have  been  allowed  by  the  Board  of  Supervisors. 

Section  1647  Howell’s  statutes  provides  that  where  a person  is  sick  or  infected  with 
a dangerous  communicable  disease,  the  local  board  of  health  of  the  township  shall 
make  such  provisions  as  they  deem  necessary  by  providing  nurses  and  other  assistance 
and  necessaries,  which  shall  be  at  the  charge  of  the  person  himself,  his  parents  or 
other  persons,  who  may  be  liable  for  his  support,  if  able;  otherwise  at  the  charge  of 
the  county  to  which  he  belongs.  Medical  attendance  is  certainly  one  of  the  “ neces- 
saries” mentioned  in  this  section. 


ABSTRACT  OF  PROCEEDINGS,  JANUARY  11,  1895. 


11 


The  Supreme  Court,  of  Michigau,  has  decided  (3rd  Mich.  Report,  p.  475)  that  when 
any  expenses  incurred  under  this  section  are  chargeable  to  the  county,  and  the  amount 
due  has  been  ascertained,  and  fixed  by  the  local  board  of  health,  it  is  the  duty  of  the 
Board  of  Supervisors  to  allow  at  once  that  amount,  and  to  provide  for  its  payment. 
The  Board  of  Supervisors  have  no  discretion  in  the  matter  further  than  to  ascertain 
whether  the  patient  or  those  who  may  be  liable  for  his  support,  are  able  to  pay, the 
expenses  incurred  under  this  section. 

The  only  criticism  that  I might  make  is  that  your  bill  should  have  been  allowed  by 
the  local  board  of  health,  then  the  Board  of  Supervisors  should  allow  “ that  amount”1 
and  provide  for  its  payment.  I advise  you  to  present  the  bill  to  the  local  board  of 
health,  and  then  again  to  the  Board  of  Supervisors,  with  a reference  to  3rd  Michigan 
Report,  475. 

I know  of  no  higher  law,  in  this  State,  than  the  decision  of  the  State  Supreme 
Court,  and  that  decision  is  very  clear,  as  is  shown  in  the  footnote  on  page  3 of  the 
pamphlet  [120]  which  I send  you  herewith.  In  another  envelope  I send  you  another 

marked  copy,  which  you  may  want  to  use,  to  show  to  Mr. that  the  “ law”  is  very 

plain,  and  not  as  his  letter  says.  (1)  The  health  officer  and  the  local  board  are 
required  to  “contract  such  bills;”  (2)  the  law,  section  1647  Howell’s  statutes,  provides 
pay  by  the  county;  and  (3)  there  has  been  appeal  from  the  Board  of  Supervisors  to  the 
Supreme  Court,  and  this  subject  has  been  decided  by  that  court  of  last  resort — 3rd 
Michigan  Report,  475.  Very  respectfully, 

Henry  B.  Baker, 

Secretary. 

Special  Investigations  by  the  Secretary. 

During  this  quarter  many  urgent  requests  have  been  made  of  this 
office  for  an  expert  diagnostician,  and  for  aid  in  restricting  communi- 
cable diseases.  Upon  an  urgent  request,  your  secretary  visited  Man- 
chester to  advise  relative  to  the  best  methods  to  adopt  for  the  restric- 
tion of  small-pox  at  that  place. 

Your  secretary  has  visited  the  townships  of  .Portland,  Sunfield, 
Bebewa  and  Danby,  Ionia  county,  to  see  whether  it  was  necessary  to 
(establish  a quarantine  under  the  State  law  against  Sebewa  and  Danby 
in  which  townships  small-pox  had  broken  out.  I advised  with  the  health 
officials  of  the  townships  and  villages  surrounding  Sebewa  and  Danby, 
concerning  how  quarantine  could  be  practically  established  by  the  local 
boards  of  health,  under  the  law  which  authorizes  the  local  board  to- 
make  and  enforce  regulations.  I also  visited  Sebewa  and  Danby,  and 
advised  with  the  acting  health  officials  of  those  townships. 

Sanitary  Conventions  at  Union  City  and  at  Charlotte. 

An  interesting  and  successful  Sanitary  Convention  was  held  under 
the  auspices  of  this  Board  at  Union  City,  Oct.  25  and  26.  Another 
Sanitary  Convention  was  held  at  Charlotte,  Nov.  22  and  23,  1894.  This 
Sanitary  Convention  also  was  a very  successful  one. 

Re-arranging  the  Secretary's  Room. 

The  secretary’s  room  has  been  thoroughly  cleaned,  and  a large  file 
case  placed  on  the  east  side  of  the  room.  Linoleum  has  been  placed 
on  the  floor,  instead  of  the  old  carpet  which  has  been  there  since  the 
Capitol  was  completed.  The  re-arranging  of  this  room  has  occasioned 
considerable  work  in  addition  to  the  regular  work  of  the  office. 

Work  in  Connection  with  Sickness  Statistics. 

During  the  fourth  quarter  of  1894,  1,875  blank  postal  report  cards,  125 
record  books  and  11  hektograph  circular  letters  regarding  weekly  card 
reports,  have  been  mailed  to  117  health  officers  and  regular  correspondents; 

3 


- 


12  MICHIGAN  STATE  BOARD  OF  HEALTH. 

1,306  weekly  card  reports  have  been  received  and  entered  on  the  register;  5 1 
copies  of  the  hektographed  weekly  bulletin  “ Health  in  Michigan,”  wer( 
mailed  each  week,  and  110  copies  of  the  monthly  bulletin  “ Health  ir 
Michigan,”  have  been  hektographed  and  mailed  each  month.  These  bul 
letins  have  been  consolidated  for  this  quarterly  report.  Work  has  alsc 
been  done  on  the  compilation  of  the  weekly  card  reports  of  sickness 
during  the  year  1893,  for  the  annual  report  for  1894. 

Health  in  Michigan  in  the  Fourth  Quarter  of  1894.  Communicable  Dis 

eases. 

Compared  with  the  preceding  quarter  (July,  August  and  September) 
reports  from  all  sources  show  scarlet  fever  to  have  increased  by  an  aver 
age  of  forty -three  places,  diphtheria  to  have  increased  by  an  average  ol 
thirty-six  places,  typhoid  fever  to  have  increased  by  an  average  of  thirty 
seven  places,  small-pox  to  have  increased  by  an  average  of  three  places 
consumption  to  have  increased  by  an  average  of  two  places  and  measles 
to  have  decreased  by  an  average  of  eleven  places. 

Meteorology  at  one  Centred  Station , and  Sickness  throughout  Michigan 
from  all  Causes , Fourth  Quarter  of  1894,  Compared 
with  the  Preceding  Quarter. 

A comparison  of  meteorological  conditions  of  the  fourth  quarter  oi 
1894,  with  the  meteorological  conditions  of  the  preceding  quarter,  shows 
the  prevailing  direction  of  the  wind  to  have  been  west  (instead  of  south 
west),  the  average  velocity  3 miles  per  hour  greater,  the  temperature 
30.02  degrees  lower,  the  rainfall  .01  of  an  inch  less,  the  absolute  humid- 
ity much  less,  the  relative  humidity  much'T&ore,  the  day  and  night  ozone 
much  less  and  the  depth  of  water  in  the*- wejl  $t  Lansing  14  inches  less 
in  the  fourth  quarter  of  1894. 

Compared  with  the  preceding  quarter  (July,  August  and  September) 
the  reports  from  regular  observers  show  a marked  increase  of  diphtheria 
influenza,  pneumonia,  pleuritis,  bronchitis,  tonsillitis  and  scarlet  fever 
and  a marked  decrease  of  cholera  infantum,  cholera  morbus,  dysentery 
diarrhea,  intermittent  fever  and  inflammation  of  bowels  in  the  fourth 
quarter  of  1894. 

The  Weather  and  the  Health  in  Michigan  in  the  Fourth  Quarter  oj 
1894 , Compared  with  the  Average  for  the  Fourth 
Quarters  in  the  Eight  Years  1886-1893. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quartei 
of  1894,  with  the  average  for  the  fourth  quarters  in  the  eight  years,  1886- 
1893,  shows  that  in  1894,  the  prevailing  direction  of  the  wind  was  tht 
same  (west),  the  velocity  .8  of  a mile  per  hour  greater,  the  temperature 
was  .65  of  a degree  higher,  the  rainfall  was  .97  of  an  inch  less,  the 
absolute  and  relative  humidity  were  nearly  the  same,  the  day  and  nighi 
ozone  were  less  and  the  depth  of  water  in  the  well  at  Lansing  was  II 
inches  less. 

Compared  with  the  average  in  the  corresponding  quarters  in  the  eight 
years  1886-1893,  the  reports  from  regular  observers  indicate  that  typhoic 
fever  was  more  than  usually  prevalent,  and  that  intermittent  fever,  typho- 
malarial  fever,  erysipelas,  consumption,  dysentery,  pneumonia  and  remit- 
tent fever  were  less  than  usually  prevalent  in  the  fourth  quarter  of  1894. 


\5% 


r 


ABSTRACT  OF  PROCEEDINGS. 

OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


ANNUAL  MEETING,  APRIL  12,  1895. 


[225] 


. [Reported  by  the  Secretary.] 


The  meeting  was  called  to  order  by  the  President.  There  were  present: 
Hon.  Frank  Wells,  President,  Lansing;  Prof.  Delos  Fall,  M.  S.,  Albion; 
George  H.  Granger,  M.  D.,  Bay  City;  and  Henry  B.  Baker,  M.  D.,  Secre- 
tary, Lansing. 

President  Wells  read  the  following  recommendations: 

“ P seem„s  proper  that  I should  call  your  attention  to  charges  made  by 
members  of  the  present  legislature  concerning  the  members  of  this  board 
during  the  recent  discussion  of  the  bill  now  before  the  legislature  known 
as  the  Miller  bill.  (House  bill  693,  File  No.  121.) 

These  charges  affect  not  only  the  business  and  professional  character 
ot  the  members  of  this  Board  but  also  their  integrity.  In  my  opinion 
self-respect  demands  that  we  request  of  the  House  of  Representatives  that 
it  appoint  a committee  for  the  purpose  of  thoroughly  investigating  these 
charges,  to  the  end  that  proper  remedies  may  be  apolied  should  all  or 
any  ot  them  be  sustained.” 

a Pftker  the  following  preamble  and  resolution, 

dratted  by  Prof.  Fall,  were  unanimously  adopted: 

Whereas,  Serious  charges  have  been  make  on  the  floor  of  the  House  of 
Representatives,  reflecting  on  the  business  and  professional  character,  as 
wed  as  the  integrity  of  the  members  of  this  Board,  therefore. 

Besolved,  That  this  board  respectfully  and  earnestly  request  the  Hon- 
orable,  the  House  of  Representatives,  to  appoint  a committee  to  investigate 
the  above-mentioned  charges,  and  that  the  committee  be  authorized  and 
ducted  to  make  a thorough  investigation  of  all  the  acts  of  this  Board. 

* It  L?°Ve  PIfamble  and  resolution  were  placed  in  the  form  of  a letter 
to  the  Honorable,  the  Speaker  and  House  of  Representatives,  signed  by 
the  President  and  Secretary,  and  immediately  sent  to  the  Speaker* 


almost  immediate  attention. 

ttesolvea , That  a committee  of  three  be  annointart  Vw  tLiq  tj — . _ „ 


Hon.  J. 


j mu  . suam’  onerea  me  ronowing  resolution: 

invSdSon  of  n°j  threebe  appointed  by  the  Speaker  of  this  House  to  make  a thorough 

LTBo£d.  ° th‘S  H°U8e  againSt  the  St8te  Board  ot  Health' in 

wite  to^efav^fdewlft.fn  wed  ^^flons,  endeavored  to  lay  the  resolution  on  the  table,  and  other- 
ItepresIntatWei  Cook  8CU881°n^  at  aft,ernoon  session,  the  resolution  was  adopted. 

T M A book’  Amidon  and  Holden  were  appointed  to  serve  on  the  above  mentioned  committee 
Later,  Mr.  Amidon  requested  to  be  excused  from  serving,  and  Mr.  Edgar  was  appoinS  iS  his  p W 


* ^ \<L  50= 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


O 


The  members  then  informally  discussed  the  action  which  had  thus  far 
been  taken  on  the  Miller  bill  (House  bill  No.  693)  and  also  informally 
considered  the  Bialy  bill  (Senate  bill  No.  329,  File  247),  which  was  pending 
in  the  Senate.  No  formal  action  was  taken. 

The  regular  business,  including  the  auditing  of  bills  and  accounts  was 
transacted. 

The  secretary  mentioned  that  he  had  received  a letter  from  the  secre- 
tary of  the  Ohio  State  State  Board  of  Health  and  a copy  of  a letter  from 
the  Meat  and  Food  Inspector  of  Toledo.  A copy  of  each  letter  was 
handed  to  each  member  of  the  board,  but  no  formal  action  was  taken  by 
the  board.* 

The  letters  are  as  follows: 


“OHIO  STATE  BOARD  OF  HEALTH,  \ 
Office  of  the  Secretary,  > 
Columbus , Ohio , April  9,  1895.  ) 

Dr.  Henry  B.  Baker,  Secretary , State  Board  of  Health , Lansing , Michigan : 

Dear  Doctor:— I enclose  herewith  a copy  of  a letter  received  from  the  meat  and  food  inspector  of 
Toledo,  Ohio.  Oar  Attorney  General  advises  that  this  constitutes  an  offense  against  the  State  of  Michigan 
on  the  part  of  Mills  & Miller,  and  that  they  should  be  dealt  with  by  the  authorities  of  your  State.  I have 
so  informed  Mr.  Sacks. 

If  any  action  is  taken  by  your  Board  in  this  matter  I should  be  pleased  to  know  of  it. 

Yours  truly, 

C.  O.  Probst, 

Secretary. 

Toledo , Ohio,  April  6, 1895. 

Dr.  Probst,  State  Health  Department,  Columbus,  Ohio: 

Dear  Sir: — I have  a case  here  which  the  school  board  of  the  Homeless  Children  and  Orphans  School 
of  Coldwater,  Michigan,  are  the  complainers.  They  had  a fat  cow  which  they  had  slaughtered  (for  their 
own  use)  by  Mills  & Miller  of  Coldwater,  Michigan.  Mills  & Miller  informed  the  board  that  the  cow  was 
diseased.  At  once  the  board  secured  two  veterinary  surgeons  to  inspect  the  meat  and  they  found  the 
lungs  badly  diseased  and  filled  with  pus,  also  found  several  tumors  on  the  meat  between  the  ribs  also 
filled  with  pus,  and  they  pronounced  the  meat  unwholesome,  and  the  board  asked  Mills  & Miller  whether 
they  could  not  dispose  of  the  meat  by  feeding  it  to  Mills  & Miller’s  hogs  that  were  about  the  slaughter 
house,  and  they  said  they  would  do  so. 

A few  days  later  Mills  & Miller  cut  the  tumors  neatly  from  the  beef  and  shipped  the  beef  to  Toledo, 
Ohio,  consigned  to  Armour  & Co.,  and  the  school  board  was  notified  to  that  effect,  and  at  once  sent  their 
superintendent  to  Toledo,  and  informed  me  of  the  facts,  I at  once  looked  after  the  case  and  found  the 
meat  at  the  Lake  Shore  freight  depot  in  the  car.  At  once  I obtained  an  order  from  Armour  & Co.,  and 
paid  the  freight  and  took  the  meat  in  my  charge,  and  I also  have  it  in  my  possession  now.  It  is  a very 
fine  looking  piece  of  meat,  weighing  between  700  and  800  pounds.  The  superintendent  identified  the  meat 
as  soon  as  he  saw  it.  The  places  where  Mills  & Miller  cut  out  the  tumors  can  plainly  be  seen.  This  is  a 
very  peculiar  case  and  I would  like  your  advice  at  once. 

Yours  respectfully, 

Caspar  Sacks, 

Meat  and  Food  Inspector." 

1610  22d  Street,  Toledo,  Ohio. 

This  being  the  Annual  meeting,  an  address  by  the  President  was  in 

order.  . . . , , . 

President  Wells  said  that  together  with  his  personal  business,  and  his 
efforts  with  the  Legislature,  and  the  fact  that  he  had  been  suffering  with 
la  grippe,  he  had  not  had  time  to  prepare  the  address  that  he  had  intended 
to  make.  However,  he  had  put  a few  remarks  on  paper,  and  would  read 
them.  His  address  was  as  follows: — 


*The  secretary  sent  a copy  to  the  Prosecuting  Attorney  of  Branch  county,  also  to  the  Attorney  General. 


ABSTRACT  OF  PROCEEDINGS  APRIL  12,  1895. 


3 


THE  ADDRESS  OF  THE  PRESIDENT  OF  THE  MICHIGAN  STATE  BOARD 
OF  HEALTH,  AT  ITS  ANNUAL  MEETING  IN  THE  CAPITOL, 

' LANSING,  APRIL  12,  1895. 

BY  HON.  FRANK  WELLS,  PRESIDENT. 

To  the  Members  of  the  State  Board  of  Health : 

Gentlemen — On  the  12th  day  of  April,  1873,  just  twenty-two  years 
ago  to-day,  the  bill  organizing  the  Michigan  State  Board  of  Health  was 
approved.  The  provisions  of  this  bill  which  became  a law  of  the  State  on 
that  day  have  never  been  changed.  The  law  is  liberal  and  comprehensive 
and  fairly  states  the  objects  sought  to  be  secured  by  the  creation  of  a State 
Board  of  Health,  so  far  as  sanitary  knowledge  and  experience  had,  at  the 
time  of  its  enactment  made  these  objects  manifest.  The  newly  created 
board  was  given  general  supervision  of  the  interests  of  the  health  and  life 
of  the  citizens  of  this  State.  It  was  required  especially  to  study  the  vital 
statistics  of  the  State  and  endeavor  to  make  intelligent  and  profitable  use 
of  these  records.  It  was  made  its  duty  to  make  sanitary  investigations  and 
inquiries  respecting  the  causes  of  disease  and  especially  of  epidemics;  also 
the  causes  of  mortality  and  the  effects  of  localities,  employments,  condi- 
tions, ingesta,  habits  and  circumstances  on  the  habits  of  the  people.  It 
was  authorized  when  required  or  when  it  might  deem  it  best  to  advise  offi- 
cers of  the  Government  or  other  State  Boards  in  regard  to  the  location, 
drainage,  water  supply,  disposal  of  excreta,  heating  and  ventilation  of  any 
public  institution  or  building.  Finally,  it  was  required  to  recommend  from 
lime  to  time  standard  works  on  the  subject  of  hygiene  for  the  use  of  the 
.schools  of  the  State. 

The  reputation  of  Michigan  for  healthfulness,  since  its  earliest  settle- 
ment had  not  been  an  enviable  one.  The  class  of  diseases  known  as  mala- 
rial had  been  of  universal  prevalence.  They  spared  neither  age,  sex  nor 
condition,  and  during  all  the  early  years  of  the  history  of  our  State,  its 
founders,  the  pioneers  and  their  children,  suffered  from  these  diseases  far 
beyond  anything  the  present  generation  can  imagine.  During  many 
months  of  the  year  over  large  areas,  harvests  could  be  but  partially  gath- 
ered, village  work  shops  and  stores  were  deserted  and  closed,  schools  were 
sparsely  attended,  and  nearly  all  the  activities  of  life  were  suspended. 
Pinched  and  sallow  faces  met  the  gaze  everywhere  and  existence  seemed  a 
burden. 

There  were  many  years  of  disease  and  misery  before  drainage  and  sun- 
light gradually  banished  these  enemies  of  human  health  and  happiness, 
until  they  have  finally  become  nearly  extinct  in  our  borders.  Scarcely  a 
hint  of  the  character  of  these  enemies  entered  the  minds  of  the  physicians 
or  sanitarians  of  those  days.  It  is  well  to  remember  the  foes  that  have 
been  vanquished,  to  record  the  history  of  the  conflicts  had  with  them,  and 
fhe  weapons  used  to  achieve  success,  for  the  campaign  is  to  consist  of  many 
conflicts,  and  in  no  warfare  is  experience  and  knowledge  of  more  value 
than  in  the  one  waged  by  sanitarians  against  the  enemies  of  health  and 
life.  Our  own  history  shows  this  to  be  true,  for  as  the  hostile  hordes  of 
malaria  disappeared,  others  more  malignant  appeared  in  our  midst.  These 
assumed  new  methods  of  attack.  They  concentrated  their  forces  and 
seemed  to  descend  upon  communities  in  battalions.  Typhoid  fever,  cerebro- 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


spinal  meningitis,  diphtheria  and  other  adversaries  of  life  became  epidemic 
in  the  cities  and  villages  of  Michigan. 

Man  was  powerless  to  resist  them  for  he  knew  little  concerning  these 
unseen  but  powerful  destroyers,  or  of  any  methods  whereby  their  constant 
and  savage  inroads  could  be  checked.  The  friends  of  the  law  creating  the 
State  Board  of  Health  were  probably  inspired  by  hope  rather  than  belief 
in  making  investigations  concerning  the  causes  of  epidemics  one  of  the 
chief  duties  of  its  members.  What  these  causes  were,  or  how  they  could 
be  sought  out  and  their  baleful  influences  counteracted  was  an  enigma  not 
yet  solved,  and  but  little  considered. 

It  was  known  that  measles,  scarlet  fever,  small-pox  and  several  other 
diseases  could,  in  some  way,  be  communicated  by  contact,  and  that  one 
attack  usually  secured  immunity  from  subsequent  attacks. 

Vaccination  for  small-pox  had  been  proved  to  be  efficacious,  and  that 
cUsease  had  largely  ceased  to  menace  the  world  with  its  horrors.  Beyond 
this,  science  had  scarcely  taken  a step  in  the  direction  of  preventing  or 
stamping  out  outbreaks  of  any  of  the  communicable  diseases,  discovering 
their  causes,  or  learning  which  of  the  diseases  that  afflict  humanity,, 
properly  belonged  to  this  class. 

Scarcely  a glimmer  of  the  light  that  was  soon  to  illumine  these  problems 
and  create  the  twin  sciences,  sanitation  and  biology,  was  then  visible. 
Revelations  of  the  microscope  concerning  low  forms  of  life  were  still 
regarded  even  by  scientific  men,  as  curiosities  of  nature  only. 

The  relation  of  some  of  these  forms  of  life  to  disease,  was  suspected  by 
some,  but  believed  in  by  only  a few  original  investigators,  in  Europe, 
whose  names  are  now  familiar  to  the  world  as  the  greatest  benefactors  of 
their  race  that  any  age  can  show.  The  story  of  the  labors  of  Schwann,  of 
Davaine,  of  Tyndall,  of  Pasteur,  Koch,  and  a host  of  later  laborers  in  the 
fields  of  enquiry  which  have  rendered  them  famous,  is  familiar  to  you  all* 
and  in  the  light  of  the  knowledge  those  labors  have  revealed,  the  path 
which  leads  to  success  and  victory  is  no  longer  the  one  of  obscurity  and 
doubt  which,  twenty-two  years  ago  your  predecessors  were  expected  to 
explore.  Sanitation  had  but  one  dogma  then.  It  was  a very  old  dogma 
and  can  never  be  superseded.  It  may  be  expressed  in  the  single  word 
cleanliness.  The  opposite  of  cleanliness  was  the  cause  of  disease.  How 
filth  caused  disease,  or  why  amid  filthy  surroundings  people  were  often 
healthy,  were  mysteries.  With  this  lack  of  the  knowledge  now  so  common,, 
the  accomplishments  of  the  State  Board  of  Health  during  the  early  years 
of  its  existence  must  have  been  of  comparatively  little  practical  value. 

It  was  five  years  after  its  formation  before  Pasteur  announced  to  the 
world  his  discoveries  concerning  anthrax,  and  it  is  from  this  date  only,. 
1877,  that  what  is  called  the  Germ  Theory  of  Disease,  may  be  said  to  have 
had  an  existence.  From  then  until  now,  what  an  expanse  of  knowledge 
concerning  the  cause  and  prevention  of  a large  proportion  of  the  diseases 
which  affect  humanity,  has  been  opened  to  our  view. 

This  knowledge  which  is  daily  widening  is  as  continually  increasing  the 
complexity  of  the  problems  it  presents.  From  a single  dogma,  sanitary 
knowledge  has  evolved  almost  at  a bound  a science  of  its  own,  correlated  to 
many  of  the  other  sciences,  and  second  to  none  of  them  in  importance. 

Its  advance  today  is  more  rapid  than  any  of  its  sisters,  and  he  who  keeps 
step  with  its  speedy  progress  must  be  familiar  with  its  history,  and  have 
the  time  and  the  ability  to  properly  digest  and  assimilate  the  facts  which 
original  workers,  all  over  the  world,  are  daily  adding  to  its  records.  The 


ABSTRACT  OF  PROCEEDINGS,  APRIL  12,  1895. 


practical  work  which  all  this  knowledge  makes  valuable  should  never  be 
entrusted  to  feeble  or  incompetent  hands.  I believe  the  history  of  the 
Michigan  State  Board  of  Health  shows  in  this  respect  a list  of  names,  of 
which  any  State  might  feel  proud,  many  of  them  being  known  beyond  the 
■confines  even  of  our  own  nation. 

I should  like  to  dwell  on  the  results  of  the  labors  of  these  men,  but  you, 
equally  with  myself,  are  familiar  with  these  results,  showing  as  they  do 
the  saving  of  thousands  of  valuable  human  lives  to  their  families  and  to 
the  State.  The  Michigan  State  Board  of  Health  has  been  a pioneer  in 
many  of  its  lines  of  life-saving  work.  It  has  nearly  always  had  among  its 
membership  men  engaged  in  original  investigations.  It  has  at  its  service, 
probably  the  best  equipped  laboratory  of  hygiene  on  the  continent,  having 
for  its  director  one  of  its  own  members,  Prof.  Vaughan,  whose  well  earned 
reputation  cannot  be  added  to  by  any  words  of  mine. 

This  laboratory  aids  greatly  the  work  of  the  State  Board  of  Health,  and 
is  of  much  value  to  physicians  and  to  the  people.  It  furnishes  facilities 
for  promptly  determining  suspected  cases  of  typhoid  fever,  diphtheria,  and 
tuberculosis.  During  the  last  two  years  meetings  of  local  health  officers 
have  been  held  at  this  laboratory,  for  conference  and  for  witnessing 
methods  for  the  detection  of  disease  organisms.  These  meetings  are 
believed  to  be  of  the  greatest  value,  and  should  certainly  be  continued. 

I have  endeavored  to  sketch  briefly,  and  it  seems  to  me  very  imperfectly, 
on  this  anniversary  occasion,  some  of  the  reasons  why  the  people  of  Michi- 
gan should  feel  thankful  for  the  law  creating  the  State  Board  of  Health,  and 
for  the  absence  of  the  epidemics,  whose  inroads  before  its  enactment,  filled 
with  mourning  thousands  of  homes.  That  this  feeling  does  exist  among 
the  people  has  been  often  manifested  at  the  popular  sanitary  conventions 
held  in  two  or  three  of  the  cities  of  the  State  every  year,  where  expressions 
of  gratitude  for  the  work  of  the  Board  are  very  common.  While  it  is  true 
that  members  of  the  Legislature,  now  in  session,  have  made  and  are  making 
serious  efforts  to  abolish  the  present  Board,  alleging  as  one  of  the  reasons 
for  such  action,  the  large  expense  of  carrying  forward  the  lines  of  work 
upon  which  this  Board  is  engaged,  yet  it  is  gratifying  to  know  that  no 
popular  demand  is  at  the  foundation  of  this  attempt.  On  the  contrary, 
there  comes  to  us  from  all  over  the  State,  not  only  from  the  medical  fra- 
ternity, but  from  citizens  generally,  expressions  of  the  deepest  concern  and 
indignation  at  such  action.  These  expressions  show  that  the  Michigan 
State  Board  of  Health  is  firmly  entrenched  in  the  esteem  and  appre- 
ciation of  the  intelligent  element  of  our  people.  This  is  not  the  first 
time  in  its  history  that  this  Board  has  been  the  target  of  ignorance  and 
malice  from  legislators  and  others  in  authority.  It  is  not  likely  to  be  the 
last. 

Many  of  the  acts  of  the  Board  are  necessarily  invasive  of  private  rights, 
and  result  in  making  enemies  of  those  who  suffer  from  such  acts.  The 
quarantine  established  by  this  Board  for  the  inspection  of  immigrants 
coming  into  this  State,  and  the  disinfection  of  their  baggage  during  the 
prevalence  of  cholera  in  Europe  was  a case  of  this  class.  This  action,  taken 
amid  frantic  appeals  made  by  the  people  to  this  Board  for  protection, 
caused  railroads  some  inconvenience,  and  was  resented  by  a few  of 
them.  It  was  even  defied  by  one,  and  led  to  litigation  that  resulted  in 
the  law  being  sustained  by  the  courts,  though  the  rules  made  by  the  Board 
were  regarded  as  exceeding  the  authority  expressed  in  the  law.  But  igno- 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


ranee  is  equally  prolific  in  provoking  opposition.  Sanitary  science  is  yet 
young,  and  comparatively  few  have  obtained  much  insight  into  its  mys- 
teries. To  such  the  present  expenditure  of  one  cent  per  capita  per  annum 
for  the  purposes  for  which  the  Michigan  State  Board  of  Health  was  created 
seems  large,  and  not  only  is  any  additional  sum  asked  for  to  protect  the 
people  from  those  diseases  known  to  be  preventable  regarded  as  unneces- 
sary, but  the  small  sum  now  used  is  considered  extravagant. 

Until  ignorance  gives  place  to  knowledge,  this  will  continue.  It  is  one 
of  the  duties  of  this  board  to  hasten  the  coming  of  that  time.  While  we 
are  doing  much  to  overcome  ignorance  by  means  of  the  distribution  of  the 
Board’s  literature,  and  the  holding  of  sanitary  conventions,  are  there  not 
other  methods  which  can  be  adopted  to  secure  this  end?  The  public 
school  is  an  avenue  through  which  we  seek,  by  legislation,  to  enter.  I 
earnestly  hope  we  may  be  enabled  to  do  so,  and  thus  begin  sanitary 
instruction  where  other  instruction  properly  begins  in  the  minds  of  our 
youth.  But  the  main  channel  by  which  information  reaches  the  people 
is  the  public  press.  It  is  to  this  that  a large  majority  turn  for  knowledge 
concerning  current  events.  The  use  made  of  this  instrument  by  the 
Michigan  State  Board  of  Health  is  extremely  limited.  It  consists  of 
little  more  than  a condensation  of  the  weekly  reports  of  sickness  statistics 
sent  to  members  and  others  from  the  office  of  the  secretary.  With  bound- 
less information  of  interest  and  value  at  hand,  with  daily  papers  willing 
to  publish  short  and  interesting  articles,  and  with  a community  willing 
and  anxious  to  absorb  knowledge  in  this  manner,  it  seems  proper  and  right 
that  this  information,  which  is  of  greater  value  than  any  other,  be  pre- 
sented to  the  people  in  the  form  in  which  they  are  disposed  to  receive  it. 

Education  being  the  chief  instrument  upon  which  we  must  rely  to 
accomplish  the  work  we  are  set  to  do,  should  we  not  use  this  instrument 
in  every  promising  field? 

To  do  so  may  require  of  us  more  of  time,  more  of  energy  and  more  of 
sacrifice  in  other  ways,  but  these  should  not  be  wanting.  We  have 
accepted  a trust  second  to  no  other  in  importance.  The  labors  and  respon- 
sibilities involved  in  this  acceptance  I believe  no  member  of  this  board 
desires  to  evade.  If  more  of  the  talents  given  to  each  one  of  you  are 
needed,  I believe  they  will  be  forthcoming.  The  spirit  and  purpose 
which  have  inspired  you  in  the  past  will,  even  if  unappreciated  by  those 
to  whom  such  spirit  and  purpose  cannot  appeal,  continue  to  animate  and 
stimulate  you  in  the  future. 

Humanity  needs  your  efforts,  and  no  higher  reward  can  crown  achieve- 
ment, in  any  department  of  human  endeavor,  than  a consciousness  of 
having  been  instrumental  in  the  saving  of  human  life  and  the  relieving  of 
human  woe. 

The  relations  which  have  existed  between  the  members  of  this  board, 
during  the  time  I have  through  your  partiality  presided  over  your  deliber- 
ations, have  been  most  friendly,  and  I desire  in  closing  to  thank  you  all 
for  the  courtesy  and  indulgence  I have  during  that  period  uniformly 
received  at  your  hands. 


ABSTRACT  OF  PROCEEDINGS,  APRIL  12,  1895. 


7 


Following  the  President’s  address,  the  election  of  a President  of  the 
Board  for  the  ensuing  two  years  was  in  order.  There  being  no  other 
nominations,  on  motion  of  Dr.  Granger,  Hon.  Frank  Wells,  was  unani- 
mously elected  president  of  the  State  Board  of  Health  for  the  ensuing 
two  years. 

The  newly-elected  president  made  a few  brief  remarks,  in  which  he 
reviewed  some  of  the  past  work  of  the  Board,  and  made  a few  suggestions 
regarding  his  views  of  some  of  the  future  plans  of  the  Board. 

The  Secretary  presented  his  quarterly  report  of  work  done  in  the  office. 
The  report  is  as  follows : 


SECRETARY’S  REPORT  OF  DANGEROUS  COMMUNICABLE  DISEASES, 
OF  WORK  DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD 
OF  HEALTH,  AND  OF  THE  CONDITION  OF  HEALTH  GEN- 
ERALLY IN  MICHIGAN  DURING  THE  QUAR- 
TER ENDING  MARCH  31,  1895. 

Dangerous  Communicable  Diseases. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  dis- 
eases in  Michigan,  received  from  all  sources  and  filed,  and  the  corres- 
ponding number  concerning  which  action  was  taken  by  this  office,  during 
the  quarter,  areas  follows:  for  diphtheria,  117;  for  scarlet  fever,  195; 
for  typhoid  and  typho-malarial  fever,  76;  for  measles,  53;  for  small- 
pox, 12;  and  for  consumption,  154.  Total  for  the  six  diseases,  601. 

The  number  of  communications  relative  to  dangerous  communicable 
diseases,  received  and  placed  on  file  during  the  quarter,  was  2,482. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards, 
and  demands  for  weekly  and  final  reports  on  cards,  or  in  the  form  of  the 
circular  letter,  were  sent  out  during  the  quarter  to  the  number  of  2,084. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  quarter 
were:  for  diphtheria,  109;  scarlet  fever,  191;  typhoid  and  typho-malarial 
fever,  91;  measles,  21;  small-pox,  12;  consumption,  2.  Total  for  the  six 
diseases,  426. 

During  the  quarter,  the  local  columns  of  942  newspapers,  have  been 
looked  over  for  reports  of  occurrence  of  communicable  diseases.  (This 
work  is  done  by  the  clerk  who  acts  as  messenger  and  janitor,  in  the  inter- 
vals of  his  performance  of  other  duties.)  This  has  resulted  in  giving  this 
office  information  of  the  alleged  occurrence  of  3 outbreaks  of  diphtheria, 
6 outbreaks  of  scarlet  fever,  2 outbreaks  of  typhoid  and  typho-malarial 
fever,  2 outbreaks  of  measles.  To  what  extent  the  reports  of  these  alleged 
outbreaks  were  verified,  is  shown  in  the  accompanying  table : 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


TABLE  I. — Showing  the  number  of  outbreaks  of  diphtheria,  Scarlet  fever , Typhoid 
fever , Measles,  Small-pox,  and  Consumption,  from  January  1,  to  March  31,  1895,  of 
which  notice  was  received  at  the  office  of  the  Michigan  State  Board  of  Health ; the 
per  cent  of  reports,  information  concerning  which  was  received  through  the  News- 
papers ; the  per  cent  of  newspaper  reports  which  were  confirmed  by  the  health  offi- 
cer; the  per  cent  of  newspaper  reports  which  were  denied  by  the  health  officer;  and 
the  per  cent  relative  to  which  no  reply  was  received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources, 
Jan.  1 to 
Mar.  31,  1895. 

Per  cent 
of  all  reports 
which  were 
obtained 
from  the 
newspapers. 

Per  cent 
of  newspaper 
reports  which 
were  con- 
firmed by  the 
health  officer. 

Per  cent 
of  newspaper 
reports  which 
were  denied 
by  the 

health  officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  health 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria 

Ill 

3 

33 

33 

33 

Scarlet  fever 

195 

3 

33 

33 

33 

Typhoid  fever 

76 

3 

0 

50 

50 

Measles 

53 

4 

0 

100 

0 

Small-pox 

12 

0 

0 

0 

0 

Consumption 

154 

0 

0 

0 

0 

Averages  for  the  six  diseases 

2 

23 

46 

31 

Small-pox  in  Michigan  in  the  first  quarter  of  1895. 


Twelve  new  outbreaks  of  small-pox  were  reported  during  the  quarter. 
These  occurred  in  Bengal  township,  Clinton  Co.  ; Southfield  township,  Oak- 
land Co.  ; Plymouth  village,  Wayne  Co.  ; Highland  Park  village,  Wayne 
Co.  ; Mayville  village,  Tuscola  Co. ; Pontiac  city  ; Royal  Oak  township,  Oak- 
land Co. ; Hamtramck  township,  Wayne  Co. ; Grand  Rapids  city ; Three 
Rivers  village,  St.  Joseph  Co.  ; Ypsilanti  city  and  Watson  township, 
Allegan  Co.  Of  these  outbreaks,  final  reports  of  those  at  Bengal,  South- 
field,  Plymouth,  Pontiac,  and  Royal  Oak,  have  been  received.  In  the 
outbreaks  at  Highland  Park,  Ypsilanti  and  Hamtramck  the  cases  have  all 
recovered,  but  no  final  reports  of  these  three  outbreaks  have  yet  reached 
this  office  at  this  date  (April  1,  1895).  Relative  to  the  alleged  outbreaks 
at  Mayville  and  Three  Rivers,  no  reports  have  been  received  at  this  office, 
at  this  date  (April  1,  1895),  from  either  of  these  localities,  since  the  “blue 
letter”  was  sent  from  this  office,  and  it  is  inferred  that  there  may  have 
been  no  small-pox  at  either  of  these  localities.  (This  has  since  been 
found  to  be  true.) 

April  1,  small-pox  is  still  present  at  Detroit,  Grand  Rapids,  and  Watson 
township. 

The  outbreak  which  began  in  Detroit  in  May,  1894,  still  continues. 
During  the  quarter  ending  March  31,  1895,  there  have  occurred  in  that 
city,  77  new  cases,  and  26  deaths,  which,  with  the  17  cases  that  were  still 
sick  at  the  close  of  the  quarter  ending  December  31,  1894,  make  a total  of 
94  cases  and  26  deaths,  during  the  first  quarter  of  1895. 


ABSTRACT  OF  PROCEEDINGS,  APRIL  12,  1895. 


9 


(From  the  beginning  of  the  outbreak  in  May,  1894,  up  to  April  1,  1895, 
there  have  occurred  in  the  city  of  Detroit  217  cases  and  60  deaths.) 

In  the  ten  outbreaks  of  small-pox,  not  including  Detroit,  and  from 
which  reports  have  been  received  during  the  quarter  ending  March  31, 
1895,  there  have  occurred  21  cases  and  only  1 death. 

In  the  five  outbreaks,  relative  to  which  final  reports  have  been  received, 
the  infection  was  in  every  instance  restricted  to  the  one  house  in  which  it 
first  occurred. 

Compiling , Editing , Proof-Reading , Printing , etc . 

The  compilation  of  reports  from  all  sources,  relative  to  Measles  in  Mich- 
igan in  1892,  has  been  completed,  and  the  work  on  proving  the  compila- 
tion for  the  article  for  the  Annual  Report  has  been  commenced. 

The  compilation  of  reports  from  all  sources  relative  to  Diphtheria  in 
Michigan  in  1893,  is  practically  completed,  and  the  material  for  the  tables 
for  the  article  for  the  Report  for  1894,  has  been  collected. 

The  article  “ Scarlet  Fever  in  Michigan  in  1892  ” has  been  written,  based 
upon  the  compilation,  and  will  be  ready  for  the  printer  as  soon  as  proved. 

The  article  “ Diphtheria  in  Michigan  in  1892  ” has  been  proved. 

The  article  “ Nuisances  in  Michigan  in  1892  ” has  been  completed. 

About  one-half  of  the  compilation  of  “ Typhoid  Fever  in  Michigan  in 
1892  ” has  been  proved. 

Short  articles  on  various  subjects,  have  been  written,  based  upon  the 
compilations,  as  follows:  Typhus  Fever,  Membraneous  Croup,  Erysipelas, 
Mumps,  Alleged  Anthrax.  Puerperal  Fever,  Chicken-pox,  Cholera  (spor- 
adic), Whooping-cough,  Rotheln,  Typho-pneumonia,  and  Small-pox. 

Proof  has  been  read  on  the  Proceedings  of  the  Union  City  Sanitary 
Convention,  on  the  latter  part  of  the  article  on  “ Meteorology  in  Michigan 
in  1892,”  and  on  the  first  portion  of  the  article  relative  to  “ Sickness 
Statistics  in  Michigan  in  1892.” 

The  work  on  printing  the  Annual  Report  for  1893  has  been  commenced 
and  about  ninety  pages  of  the  report  have  already  been  printed. 

Making  Diagrams , Tables , etc. 

A table  has  been  made,  showing  the  numbers  of  cases  of  Sickness  and 
Deaths  from  Diphtheria,  Scarlet  Fever  and  Small-pox,  reported  to  have 
occurred  in  Detroit  during  each  week  of  the  years  1890-95  as  reported  to 
this  office  by  the  Health  Officer  of  Detroit. 

A Map — Distribution  of  Scarlet  Fever  in  Michigan  in  1892 — has  been 
made. 

A large  diagram  (32  by  45  inches)  has  been  made  in  India  ink  to  illus- 
trate the  relative  importance,  in  Michigan,  of  the  principal  communicable 
diseases — Consumption,  Pneumonia,  Diphtheria,  Typhoid  Fever,  Scarlet 
Fever,  Whooping-Cough,  Measles,  and  Small-pox. 

Hektograph  Work. 

Hektograph  work  to  the  number  of  4,246  pages  has  been  made,  of  which 
about  355  pages  were  relative  to  the  small-pox  situation  in  Michigap  since 
January  1,  1895,  being  in  the  form  of  tabular  statements.  A large 
proportion  of  the  remaining  pages  relates  to  public-health  legislation  in 
Michigan  in  1895. 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Accessions  to  the  Library,  Card- Cataloguing,  etc. 

About  60  books  and  pamphlets,  and  some  300  numbers  of  journals 
(weeklies,  monthlies,  quarterlies)  have  been  received  and  entered  in  the 
library  accession  book  of  the  office. 

Work  on  the  card-catalog  of  the  library  has  been  continued. 

Work  in  connection  with  the  financial  accounts  of  the  office  has  been 
continued. 

Annual  Reports  from  Health  Officers  and  Clerks  for  1894. 

Annual  reports  for  the  year  1891  have  been  received  from  1170  health 
officers  and  from  1145  clerks  of  townships,  cities  and  villages  in  Michigan. 
These  reports  convey  to  this  office  information  relative  to  the  prevalence 
of  each  dangerous  communicable  disease,  and  the  .condition  of  health,  and 
health  work  in  each  jurisdiction. 

On  February  28,  a ‘‘Second  request  for  annual  report,”  was  sent  to  1,392 
health  officers  and  clerks  from  whom  no  report  had  yet  been  received;  and 
on  March  31,  a “Third  request”  was  sent  to  the  health  officers  of  215 
localities  from  which  no  report  from  either  health  officer  or  clerk  had  been 
received. 

Of  the  1,578  localities  in  Michigan,  including  townships,  cities  and  villa- 
ges, annual  reports  have  been  received  from  1,419,  leaving  at  the  end  of 
this  quarter  159  localities  delinquent.  Of  these  delinquent  localities,  9 are 
townships  which  are  either  in  a disorganized  condition,  or  from  which 
neither  the  name  of  a supervisor  or  clerk  has  been  returned  for  several 
years. 

Reports  of  Medical  Practitioners  in  their  jurisdictions  have  been  received 
from  531  clerks  of  townships,  cities  and  villages. 

Work  on  Meteorology. 

The  regular  tri-daily  meteorological  observations  have  been  continued 
at  this  station,  and  a summary  for  each  week  and  month  during  the  quarter 
has  been  made  for  use  in  this  office  in  connection  with  sickness  statistics. 
The  monthly  summary  has  been  sent  at  the  end  of  each  month  to  the 
Director  of  the  Michigan  Weather  Service,  formerly  at  Detroit,  now  at 
Lansing,  for  his  use;  it  is  sent  by  him  to  the  Chief  of  the  U.  S.  Weather 
Bureau  at  Washington,  D.  C. 

. Nearly  all  the  exhibits  for  the  Annual  Report  for  1894,  have  been 
computed. 

Ozone  test-paper  (supply  for  three  months)  was  sent  to  each  of  17 
meteorological  observers  in  Michigan. 

Meteorological  registers  for  the  last  9 months  of  1894  have  been  received 
for  each  of  11  stations,  examined  and  computed,  barometer,  relative  and 
absolute  humidity  excepted. 

Diagrams  have  been  made  relating  to:  Average  Temperature,  Av. 
Daily  Range  of  Temperature,  Absolute  and  Relative  Humidity,  Per  Cent 
of  Cloudiness,  Rainfall,  Day  and  Night  Ozone,  Velocity  of  the  Wind, 
Barometric  Pressure  at  Stations  in  Michigan,  and  Velocity  of  the  Wind  at 
Lansing,  all  for  year  1893;  also  diagrams — Relation  of  sickness  from 
Pneumonia  to  the  Av.  Atmospheric  Temp,  for  four  months,  Sept,  to  Dec., 
1894,  at  Calumet,  Mich.,  and  Death-Rates  in  Michigan  during  each  of  25 


ABSTRACT  OF  PROCEEDINGS,  APRIL  12,  1895. 


11 


years,  1869-93,  per  100,000  population  from  following  diseases, — Consump- 
tion, Diphtheria  and  Croup,  Scarlet  Fever,  Typhoid  Fever,  Measles,  Small- 
pox, Whooping-Cough,  Cancer  and  Pneumonia. 

Hektograph  copies  of  a form  for  “ Measurements  of  Ground- Water  ” 
have  been  made  for  use  of  Meteorological  Observers  for  the  Michigan 
State  Board  of  Health. 

A map  was  made,  in  photo-engraving  ink,  showing  Spencer  and  Oak- 
field  townships,  Kent  Co , and  lakes  No.  3 and  4 with  dam  at  outlet  of  one 
of  the  lakes,  whereby  a nuisance  was  caused  by  over-flow  in  consequence 
of  said  dam;  also  a map  of  the  township  of  Jefferson,  Hillsdale  Co.,  show- 
ing lakes  and  rivers,  drains  and  marshes,  where  an  alleged  nusiance  was 
caused  by  the  overflowing  of  low  lands,  by  a dam  in  the  city  of  Hillsdale. 


Distribution  of  Publications , etc. 

About  800  copies  of  the  Proceedings  of  the  last  regular  meeting  (Jan. 
11,  1895),  have  been  distributed  to:  Members  and  ex-members  of  this 
Board,  Sanitary  Journal  Exchanges,  Meteorological  Observers  and 
exchanges,  members  of  Board  of  Correction  and  Charities,  health  officers 
of  cities  and  villages,  presidents  and  secretaries  of  previous  sanitary  con- 
ventions, members  of  the  Legislature,  and  to  Sanitarians. 

About  200  copies  of  the  Proceedings  of  the  regular  meeting,  held  at 
Lansing,  Oct.  12,  1894,  have  been  distributed  to  sanitarians. 

About  1,200  copies  of  the  Proceedings  of  the  Second  Annual  Conference 
of  Michigan  Health  Officers,  at  Ann  Arbor,  and  about  1,200  copies  of  the 
Proceedings  of  the  Sanitary  Convention  held  at  Union  City,  have  been 
distributed  to:  Members  and  ex-members  of  this  Board,  sanitary  journal 
exchanges,  meteorological  observers  and  exchanges,  members  of  the  Board 
of  Correction  and  Charities,  secretaries  of  other  State  Boards  of  Health, 
health  officers  of  cities  and  villages,  presidents  and  secretaries  of  previous 
sanitary  conventions,  and  to  Sanitarians.  About  150  copies  of  the 
Proceedings  of  the  Ann  Arbor  Conference  were  sent  to  members  of  the 
Legislature. 

About  200  copies  of  the  Annual  Report  of  the  Board  for  1892  have  been 
distributed  to  sanitarians  in  this  and  other  States  and  Countries. 

During  the  quarter  1,939  envelopes  were  addressed  to  1,211  supervisors 
of  townships,  294  presidents  of  villages,  294  clerks  of  villages,  70  mayors 
of  cities  and  70  clerks  of  cities.  In  each  envelope  was  sent  a circular 
letter  of  instruction  and  a blank  form  for  the  return  of  the  name  and  post- 
office  address  of  the  health  officer  for  the  ensuing  year,  and  a return 
envelope.  At  the  same  time  and  in  the  same  envelope  there  was  sent  to 
each  clerk  of  a city  and  to  each  supervisor  of  a township  a blank  to  be 
handed  to  the  clerk  of  the  city  or  to  the  clerk  of  the  township  for  his  pur- 
pose in  keeping  a record  of  each  physician  and  each  under  graduate  prac- 
ticing medicine  in  the  township  or  city  as  the  case  may  be;  at  the  same 
time,  in  case  there  is  an  incorporated  village  within  the  township,  the 
supervisor  of  the  township  is  sent  an  extra  blank  for  keeping  a record  of 
physicians  and  under-graduates  to  be  handed  to  the  clerk  of  the  village. 

About  the  usual  numbers  of  pamphlets  on  the  restriction  and  prevention 
of  the  different  dangerous  diseases  were  sent  to  the  health  officers  of  local- 
ities in  which  dangerous  diseases  have  been  reported.  It  was  at  the  same 
time  requested  of  these  health  officers  that  the  pamphlets  be  distributed 


12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


to  the  neighbors  of  the  persons  sick  icith  such  diseases  and  to  such  other 
persons  as  they  would  be  likely  to  benefit.  In  response  to  special  requests 
of  sanitarians  in  this  and  other  States,  copies  of  annual  reports,  proceed- 
ings of  sanitary  conventions,  proceedings  of  meetings  of  the  board,  and 
pamphlets  on  the  restriction  and  prevention  of  the  dangerous  communi- 
cable diseases,  have  been  sent  where  it  was  thought  likely  to  benefit  pub- 
lic health  interests. 

The  usual  record  of  distribution  of  publications  has  been  kept. 

Transportation  of  Corpses  Dead  of  Tuberculosis. 

In  a letter  dated  April  11,  1895,  John  L.  Freeman,  General  Baggage 
Agent  of  the  Lake  Shore  and  Michigan  Southern  Railway  Co.,  wrote  to 
know  how  bodies  dead  of  Consumption  were  to  be  treated  by  the  railroad 
authorities,  the  agent  at  Grand  Rapids,  Michigan,  having  received  a 
corpse  dead  of  Consumption  the  transit  permit  reading  “ Contagious 
Disease.” 

The  following  is  the  Secretary’s  reply: 

STATE  BOARD  OF  HEALTH,  MICHIGAN,  ) 
Office  of  the  Seobetaby,  > 
Lansing , April  13,  1395.  ) 

John  L.  Freeman , General  Baggage  Agent , Lake  Shore  and  Mich.  Southern  Ry.  Co.,  Cleveland , Ohio: 

Deab  Sib— Your  letter  of  April  11,  transmitting  letter  of  March  29  from  J.  W.  Lawton,  Grand  Rapids, 
relative  to  corpse  dead  of  consumption,  is  before  me. 

The  State  Board  of  Health  of  Michigan,  Sept.  30, 1893,  adopted  a resolution  “ That  hereafter,  consump- 
tion (and  other  diseases  due  to  the  Bacillus  tuberculosis ) shall  be  included  in  the  official  list  of  ‘ diseases 
dangerous  to  the  public  health.’  ” In  this  resolution  the  question  of  isolation  of  the  patient  is  not 
mentioned,  and  the  question  of  the  spread  of  the  disease  from  a corpse  has  never  been  acted  upon  by  this 
Board. 

The  subject  has  not  reached  such  a definite  stage  that  I can  give  you  definite  advice.  I think  most 
sanitarians  still  hold  to  the  belief  that  there  is  not  much  danger  of  consumption  being  spread  by  a corpse, 
yet,  inasmuch  as  consumption  is  the  most  dangerous  disease,  I incline  to  the  view  that  it  would  be  safest 
for  ,the  public  and  also  for  your  company  to  include  bodies  of  those  dead  from  consumption  under 
sections  2 and  3,  Rule  52,  adopted  by  the  American  Association  of  General  Baggage  Agents,  at  Mackinaw, 
July,  1892.*  Very  respectfully, 

Henby  B.  Bakeb, 

Secretary. 

Is  Testing  Eyes  and  Fitting  Glasses  Practicing  a “ Branch  of  Medicine?” 

During  the  quarter  the  Secretary  has  received  letters  asking  whether  or 
not  testing  eyes  and  fitting  glasses  is  a branch  of  medicine,  and  whether 
persons  doing  such  work  should  not  be  required  to  comply  with  the  State 
law  regulating  the  practice  of  medicine.  It  is  claimed  by  oculists,  that  a 
lens  is  a surgical  appliance  for  overcoming  an  optical  defect,  and  that  he 
who  tests  eyes  and  adjusts  glasses  is  practicing  a branch  of  medicine,  and 
should  register  in  the  office  of  the  county  clerk  in  accordance  with  the 
State  law  regulating  the  practice  of  medicine,  before  he  or  she  is  legally 
authorized  to  practice  this  branch  of  medicine.  The  opinion  of  the  State 
Board  of  Health  has  been  asked,  and  the  subject  should  have  been  placed 

* Section  two  of  Rule  52,  designates  how  bodies  dead  from  contagious,  infectious,  or  communicable 
diseases,  must  be  prepared  before  the  railroads  will  accept  them  for  transportation. 

Section  3 provides  that  no  infected  clothing  shall  accompany  the  body  except  that  which  is  in  the 
coffin  or  box,  and  also  requires  affidavits  stating  how  the  body  has  been  prepared  and  kind  of  coffin  or 
casket  used. 


ABSTRACT  OF  PROCEEDINGS,  APRIL  12,  1895. 


13 


before  the  Board  had  there  been  opportunity.  During  the  interval  of  a 
meeting  the  Secretary  made  the  following  reply  to  a letter  on  this  subject: 

STATE  BOARD  OF  HEALTH,  MICHIGAN,  ) 
Office  of  the  Secretary,  > 

Lansing , Feb.  21, 1895.  ) 

A.  Overfield , M.  D.,  Houghton , Michigan: 

Dear  Doctor  I send  you  by  this  mail  a copy  of  the  pamphlet  proceedings  of  this  Board  at  its  meeting 
in  April,  1894,  in  which  you  will  find  marked  paragraphs  relative  to  the  subject  of  your  letter  tome 
Feb.  19. 

Replying  to  your  letter  of  Feb.  19, 1 send  you  herewith  a copy  of  the  law  regulating  the  practice  of 
medicine  in  Michigan.  It  provides  that  every  person  practicing  medicine  and  surgery  “ in  all  [any  of  ?] 
its  departments  ” shall  be  a graduate  of  a legally-authorized  medical  college  in  this  or  any  other  country, 
and  shall  file  with  the  county  clerk  a statement  relative  to  his  medical  education  and  graduation. 
The  question  would  be  whether  testing  and  fitting  the  eyes  with  glasses,  is  one  of  the  “branches”  or 
“ departments  ” of  medicine.  If  so,  the  individual  could,  perhaps,  be  punished  under  the  State  law.  I 
presume  it  would  rest  with  the  court,  or  the  jury  in  case  a jury  trial  was  had,  to  decide  that  point.  There 
is  no  telling  how  they  might  decide  it.  For  myself  I am  inclined  to  believe  such  practice  is  a branch  of 
medical  practice,  and  should  be  regulated  by  the  law  relative  to  the  practice  of  medicine. 

Very  respectfully, 

Henry  B.  Baker, 

Secretary . 

INVESTIGATION  OF  OUTBREAKS  OF  COMMUNICABLE  DISEASES. 

March  21,  1895,  the  Secretary  of  the  State  Board  of  Health  received  a 
telegram  from  Allegan,  Michigan,  as  follows: 

“Small-pox  reported  here,  disputed,  can  you  send  expert  immediately? 
— John  Germain , health  officer  of  Watson .” 

This  was  received  very  late  at  night.  The  Secretary  telegraphed  as 
follows:  “Isolate  patient,  vaccinate  all  exposed.  Will  try  to  send  expert 
tomorrow.” 

March  22,  the  Secretary  telegraphed  Doctor  George  H.  Granger,  member 
of  State  Board  of  Health,  as  follows:  “Small-pox  reported  at  Watson, 
Allegan  County,  diagnosis  disputed,  want  expert  immediately,  will  you  go 
and  “Investigate  ?”  The  following  reply  was  received:  “Cannot  leave  my 
business.  Have  several  very  sick  patients. — Geo.  H.  Granger .” 

The  same  telegram  sent  to  Doctor  Granger  was  then  sent  to  Doctor 
Victor  C.  Vaughan,  member  of  State  Board  of  Health,  and  reply  was 
received  as  follows:  “Caunot  go.  Ask  Mulheron. — V.  C.  Vaughan ” 

The  same  telegram  was  then  sent  to  Doctor  Samuel  G.  Milner,  member 
of  State  Board  of  Health,  and  a reply  was  received  as  follows:  “I  cannot 
go,  but  Hazlewood  will. — Milner .” 

A similar  telegram  was  sent  to  Mason  W.  Gray,  M.  D.,  member  of  State 
Board  of  Health,  and  the  following  reply  was  received:  “Cannot  go,  try 
some  one  else. — Mason  W.  Gray.” 

March  22,  the  following  telegram  was  sent  to  John  Germain,  health 
officer  of  Watson,  Allegan  County,  Michigan:  “ No  member  of  Board  could 
go.  Doctor  Cattermole  of  this  office  will  reach  Allegan  8:16  tomorrow 
morning. — Baker , Secretary.” 

March  23,  Doctor  Cattermole  telegraphed  the  Secretary  of  the  State 
Board  of  Health,  as  follows:  “One  case  diagnosed  Varioloid.  Sick  ten 
days.  Many  persons  exposed,  but  active  measures  are  being  taken  in  vac- 
cination and  isolation.  Will  start  home  tonight.” 

This  experience  teaches  the  difficulty  of  relying  upon  members  of  the 
State  Board  of  Health,  who  are  engaged  in  active  practice  as  physicians, 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


for  service  as  Contagious-Disease  Inspectors.  In  this  instance  every  medi- 
cal member  of  the  Board  was  asked  to  go,  and  every  one  found  it  imprac- 
ticable to  do  so.  (It  was  impracticable  for  the  Secretary  to  go,  because  of 
pressing  official  duties  in  the  office  of  the  Board,  aud  especially  as  the 
Correspondence  Clerk  chanced  to  be  absent.  ) This  is  only  one  of  many 
instances,  which  are  being  constantly  repeated,  in  which  the  need  of  a 
State  Communicable-Disease  Inspector  is  rendered  imperative. 

Small-pox  in  Watson,  Allegan  County. 

Report  of  an  investigation  by  Dr.  Cattermole,  of  the  Office  of  the  State 
Board  of  Health: 

Lansing,  Michigan,  ) 
March  26,  1895.  ) 

Henry  B.  Baker,  M.  D.,  Secretary  of  State  Board  of  Health,  Lansing,  Michigan: 

Dear  Doctor— The  following  is  my  report  of  the  special  investigation  of  a suspected  case  of  small- 
pox, located  in  Watson  township,  Allegan  Co.,  Michigan,  in  which  investigation  I was  engaged  on  the  23d 
and  24th  days  of  March,  1895.  The  facts  of  interest  in  the  case  are  as  follows:— 

I arrived  in  Allegan  Saturday  morning,  March  23,  and  went  first  to  see  E.  D.  Osmon,  M.  D.,  health  officer 
of  the  village  and  also  of  the  township  of  Allegan,  who  told  me  that  the  suspected  case  of  small-pox  was 
in  the  adjoining  township  of  Watson,  and  that  Dr.  Charles  Russell  of  Allegan,  who  was  attending  the  case, 
would  take  me  out  to  see  it. 

1 was  taken  to  the  office  of  Dr.  Russell  and  there  met  John  Germain,  the  father  of  the  sick  boy,  who 
said  that  he  was  not  the  health  officer  of  Watson  township,  but  had  signed  himself,  when  telegraphing  to 
Secretary  Baker,  to  avoid  delay,  as  the  health  officer  lived  on  the  opposite  side  of  the  township. 

The  reason  given  for  telegraphing  to  the  Secretary  of  the  State  Board  of  Health  to  send  an  expert  there 
was  not  from  any  doubt  in  the  minds  of  the  physicians  as  to  the  nature  of  the  disease,  but  Germain  would 
not  accept  their  diagnosis,  he  maintained  that  it  was  a case  of  “German  Measles,”  and  telegraphed  the 
Secretary  of  State  Board  of  Health  signing  himself  health  officer. 

Mr.  Germain  is  Drain  Commissioner  of  Allegan  County,  and  gets  home  only  once  or  twice  a week.  He 
had  not  been  home  then  since  Sunday,  March  17.  His  duties  keep  him  traveling  about  the  county ; he  had 
also  been  in  Grand  Rapids,  about  three  weeks  before  I saw  him. 

After  talking  with  Germain,  I went,  in  company  with  Dr.  Russell,  to  see  the  case. 

The  farm  house  where  the  case  is  quarantined  is  about  four  miles  east  of  the  village  of  Allegan,  and  only 
a short  distance  over  the  line  separating  the  township  of  Allegan  from  the  township  of  Watson.  The 
house  is  of  fair  size  and  in  good  sanitary  condition.  It  stands  back  from  the  public  highway  about  five 
rods,  and  near  the  road  was  a signboard  bearing  the  words  “ Small-pox  here.” 

The  case,  Eddie  Germain,  12  years  old,  attended  the  district  school  on  Wednesday,  March  13,  but  was 
not  feeling  well  that  day.  He  remained  at  home  on  Thursday,  suffering  from  severe  pains  in  his  back  and 
legs:  he  was  vomiting  and  having  epigastric  pains  for  several  days.  Had  fever,  his  mother  says,  and  that 
his  feet  began  to  swell  at  this  time ; they  were  still  swollen  when  I saw  him,  March  23,  which  was  ten  days 
after  he  first  complained  of  feeling  sick. 

His  mother  says,  the  rash  appeared  first  Saturday  evening,  March  16,  as  red  spots  on  the  face.  Sunday, 
March  17,  Dr.  W.  E.  Albright  of  Allegan  was  passing  the  house  and  they  called  him  in  to  see  the  boy.  He 
called  it  a case  of  the  “grippe.” 

On  this  same  Sunday  there  were  a number  of  the  neighbors  in  the  house,  and  the  neighbors  visited  the 
house  as  late  as  Tuesday,  March  19,  when  an  old  lady  said  it  was  a case  of  “ Dutch  measles this  alarmed 
the  mother,  and  on  Wednesday,  March  20,  they  sent  to  Allegan  for  Dr.  Russell  to  come  out  and  see  the 
case.  He  saw  the  boy  Wednesday  evening,  and  says  the  case  then  presented  the  vesicular  stage  of 
varioloid. 

Dr.  Russell  telephoned  to  Grand  Rapids  that  evening  for  vaccine  points  and  the  next  morning  went  to 
the  Germain  home  accompanied  by  Dr.  Edward  Amsden,  who  had  had  considerable  experience  with 
small-pox  during  the  war.  Dr.  Amsden  concurred  in  the  diagnosis  of  varioloid,  and  the  Doctors  at  once 
vaccinated  such  members  of  the  family  as  were  then  at  home. 

The  family  consists  of  the  father,  who  was  then  in  Allegan  (he  was  vaccinated  that  same  day),  the 
mother  and  five  boys  (including  the  sick  child).— ages  of  boys  from  five  to  twenty-one,— were  all  vaccina- 


ABSTRACT  OP  PROCEEDINGS,  APRIL  12,  1805. 


15 


ted  on  Thursday  morning;  a daughter,  who  works  in  Allegan  was  at  home  on  Sunday  and  then  returned 
to  her  place  in  town,  but  was  sent  home  Saturday  evening,  March  28.  The  father  went  home  at  the  same 
time,  as  the  people  of  Allegan  objected  to  his  remaining  in  that  village. 

When  I saw  the  case  on  Saturday  morning,  March  23  (the  tenth  day  of  the  disease),  the  boy  had  a 
temperature  of  101-1-2  F.  Tongue  coated,  pain  in  the  epigastrium.  Over  the  face,  ears,  hands,  and 
especially  about  the  elbow  and  knee  joints,  there  were  numbers  of  dark  red  scabs  from  the  size  of  a grain 
of  wheat  to  that  of  a pea  (1  to  3 tenths  of  an  inch) . The  scabs  were  raised  above  the  surface  of  the  skin, 
dry  and  hard  to  the  touch  and  having  an  indurated  base.  Those  crusts  which  had  not  been  disturbed  by 
scratching,  presented  slight  umbilication.  Only  one  spot  had  the  appearance  of  a pustule,  the  others 
being  uniformly  dark  red  in  color.  The  only  symptom  which  seemed  to  be  lacking  to  make  it  a well 
defined  case  of  small-pox  was  the  abortion  of  the  case  before  reaching  the  stage  of  pustulation.  The  boy 
has  a large  scar  on  the  left  arm,  the  result  of  vaccination  less  than  two  years  ago. 

We  returned  to  Allegan,  and  met  some  neighbors  of  S.  P.  Albertson,  health  officer  of  Watson  township, 
conversed  with  them  relative  to  what  the  State  Board  of  Health  would  recommend  them  to  do  in  this 
case.  I sent  my  credentials  and  a marked  copy  of  the  pamphlet.  “ The  Work  of  Health  Officers  and  of 
Local  Boards  of  Health  in  Michigan  ” to  Mr.  Alberton,  saying,  that  if  the  local  health  officials  were  still 
dissatisfied  with  the  diagnosis  of  the  case,  that  the  Secretary  of  the  State  Board  would  recommend  them 
to  employ  Dr.  John  Mulheron  of  Detroit,  or  Dr.  Arthur  Hazelwood  of  Grand  Rapids,  as  expert,  but  that 
under  the  circumstances,  the  fees  and  expenses  of  these  gentlemen  could  not  be  defrayed  by  the  State 
Board  of  Health. 

Dr.  Russell  offered  to  vaccinate  all  persons  who  had  been  exposed,  if  Mr.  Albertson  would  have  them 
meet  at  the  district  school  house  next  day  (Sunday),  and  notify  him  when  to  meet  them  there.  Dr. 
Russell  telephoned  to  Grand  Rapids  for  vaccine  points,  which  were  received  Saturday  evening. 

I expected  to  meet  Mr.  Albertson  on  Saturday  afternoon,  but  he  did  not  come  into  town.  On  Sunday 
morning,  I am  told,  he  called  at  Dr.  Russell’s  house  to  say  that  the  children  of  school  district  No.  10,  would 
meet  the  Doctor  at  the  school  building  that  afternoon.  I did  not  see  him,  and  he  was  not  at  the 
school  house  that  afternoon.  I accompanied  Dr.  Russell  that  day,  and  we  vaccinated  68  persons,  mostly 
children  in  attendance  at  that  school.  Many  of  them  received  primary  vaccination. 

The  children  had  been  there  to  school  the  Friday  before,  but  the  parents  who  were  present  promised  to 
close  the  school  for  at  least  two  weeks,  and  then  if  no  new  cases  occurred,  to  use  it  only  after  thorough 
fumigation  with  sulphur. 

As  to  the  probable  source  of  contagium  in  the  case  of  Eddie  Germain,  all  that  we  could  learn  was,  that 
his  father  traveled  about  the  country  most  of  the  time,  coming  in  contact  with  ail  classes  of  people ; he 
had  also  visited  Grand  Rapids  since  the  outbreak  of  small-pox  in  that  city. 

The  teacher  in  the  district  school  spends  his  Saturdays  and  Sundays  in  Otsego,  where  there  are  some 
paper  mills  (these  paper  mills  are  thought  to  have  been  the  source  of  an  outbreak  ef  small-pox  which 
occurred  in  Otsego  about  two  years  ago,  in  which  there  were  several  cases  and  one  death). 

John  Shay,  who  lives  on  the  adjoining  farm  to  that  occupied  by  John  Germain,  has  a son  who  works  in 
the  Otsego  paper  mills;  he  usually  spends  Sunday  at  his  father’s  home.  One  of  Shay’s  daughters,  a girl 
about  fifteen  years  old,  attends  the  village  school  at  Otsego;  she  spends  her  Saturdays  and  Sundays  at 
home.  About  three  weeks  ago  this  girl  had  what  they  say  was  German  measles,  and  her  two  younger 
sisters  had  the  rash  a few  days  later;  the  two  younger  girls  attend  the  district  school  (No.  10).  Their 
mother  says,  the  rash  lasted  about  two  days;  the  girls  were  not  very  sick.  They  said,  the  “ German 
measles,”  had  prevailed  in  the  Otsego  schools  for  some  time. 

After  vaccinating  as  stated  above,  and  explaining  such  methods  of  restriction— vaccination,  isolation 
and  disinfection— as  are  recommended  by  the  State  Board  of  Health,  I left  the  neighborhood  Sunday 
evening.  The  case  of  Eddie  Germain  was  doing  well  and  in  good  way  for  a speedy  recovery ; there  were 
no  new  cases  reported. 

I left  Allegan  on  Monday  morning,  without  gaining  any  more  information. 

I am,  yours  very  respectfully, 

Geo.  H.  Cattermole. 

WORK  IN  CONNECTION  WITH  SICKNESS  STATISTICS. 

During  the  first  quarter  of  1895,  2,205  blank  postal  report  cards,  147 
record- books  and  27  hektographed  circular  letters  regarding  weekly  card- 
reports,  have  been  mailed  to  139  health  officers  and  regular  correspondents; 
1,202  weekly  card- reports  have  been  received  and  entered  on  the  register; 


16 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


53  copies  of  the  hektographed  weekly  bulletin,  “ Health  in  Michigan,” 
were  mailed  each  week,  and  107  copies  of  the  monthly  bulletin,  “ Health 
in  Michigan”  have  been  hektographed  and  mailed  each  month.  These 
bulletins  have  been  consolidated  for  this  quarterly  report.  The  com- 
pilation of  the  weekly  card-reports  of  sickness  during  the  year  1893,  for 
the  annual  report  for  1894,  have  been  completed  during  this  quarter. 


Health  in  Michigan  in  the  First  Quarter  of  1895.  Communicable  Diseases . 

Compared  with  the  preceding  quarter  (October,  November  and  Decem- 
ber, 1894),  reports  from  all  sources  show  typhoid  fever  to  have  decreased 
by  an  average  of  seventy-two  places,  diphtheria  to  have  decreased  by  an 
average  of  twenty-four  places,  measles  to  have  increased  by  an  average  of 
thirteen  places  and  scarlet  fever  to  have  increased  by  an  average  of  one 
place.  There  were  the  same  number  of  cases  of  small-pox  as  in  the  pre- 
ceding quarter. 


Meteorology  at  one  Central  Station , and  Sickness  throughout  Michigan 
from  all  Causes,  First  Quarter  of  1895 , Compared  with  the 
Preceding  Quarter. 

A comparison  of  meteorological  conditions  of  the  first  quarter  of  1895, 
with  the  meteorological  conditions  of  the  preceding  quarter,  shows  the 
prevailing  direction  of  the  wind  to  have  been  the  same  (south-west),  the 
average  velocity  4.1  miles  per  hour  greater,  the  temperature  47.28  degrees 
lower,  the  rainfall  .11  of  an  inch  more,  the  absolute  humidity  much  less, 
the  relative  humidity  slightly  less,  the  day  and  night  ozone  less,  and  the 
depth  of  water  in  the  well  at  Lansing  22  inches  less  in  the  first  quarter  of 
1895. 

Compared  with  the  preceding  quarter  (October,  November  and  Decem- 
ber), the  reports  from  regular  observers  show  a marked  increase  of 
influenza,  pleuritis  and  pneumonia,  and  a marked  decrease  of  remittent 
fever,  diarrhea  and  intermittent  fever  in  the  first  quarter  of  1895. 


The  Weather  and  the  Health  in  Michigan  in  the  First  Quarter  of  1895y 
Compared  with  the  Average  for  the  Nine  Years,  1886-1894. 

A comparison  of  the  meteorological  conditions  of  the  first  quarter  of 
1895,  with  the  average  for  the  first  quarters  in  the  nine  years,  1886-1894, 
shows  that  in  1895,  the  prevailing  direction  of  the  wind  was  the  same, 
(south-west),  the  velocity  was  1.2  miles  per  hour  greater,  the  temperature 
was  5.03  degrees  lower,  the  rainfall  was  .52  of  an  inch  less,  the  absolute 
and  relative  humidity  and  the  day  and  night  ozone  were  all  less,  and  the 
depth  of  water  in  the  well  at  Lansing  was  21  inches  less. 

Compared  with  the  average  in  the  corresponding  quarters  in  the  nine 
years  1886-1894,  the  reports  from  regular  observers  indicate  that  erysipelas, 
remittent  fever  and  intermittent  fever  were  more  than  usually  prevalent, 
and  that  consumption  and  inflammation  of  bowels  were  less  than  usually 
prevalent  in  the  first  quarter  of  1895. 


ABSTRACT  OF  PROCEEDINGS 


OF  THE 

MICHIGAN  STATE  BOARD  OF  HEALTH. 


QUARTERLY  MEETING,  JAN.  8,  1897. 


[235]  [Reported  by  the  Secretary. J 

The  Michigan  State  Board  of  Health  met  in  regular  quarterly  meeting 
at  the  State  Capitol,  January  8.  The  meeting  was  called  to  order  by  the 
president,  Hon.  Frank  Wells,  of  Lansing.  The  other  members  present 
were:  Prof.  Delos  Fall,  of  Albion,  Judge  A.  V.  McAlvay,  of  Manistee, 
and  Secretary  Henry  B.  Baker,  of  Lansing. 

The  regular  business  of  auditing  bills  and  accounts  was  transacted. 

Pneumonia  a Communicable  Disease. 

Prof.  Fall  mentioned  that  there  had  recently  been  brought  to  his  atten- 
tion an  outbreak  of  pneumonia  which  tended  to  show  the  communicabil- 
ity of  the  disease.  There  were  five  # cases  with  two  deaths,  which  all 
seemed  to  have  been  spread  directly,  one  after  another,  from  preceding 
cases. 

That  pneumonia  is  a germ  disease  has  been  demonstrated;  that  it  is  a 
dangerous  communicable  disease  there  is  no  question.  It  is  now 
known  that  exposure  to  cold  and  to  the  germs  causes  pneumonia.  There 
are  at  least  two  species  of  germs,  either  one  of  which  causes  pneumonia. 
Just  which  one  was  present  in  this  instance  was  not  ascertained.  Prob- 
ably, after  a time,  we  shall  be  able  to  distinguish  the  different  forms  of 
the  disease  due  to  the  different  germs.  But,  before  this  can  be  done, 
' physicians  who  have  such  outbreaks  in  charge  must  see  that,  from  the 
germs  present,  cultures  are  made  by  some  competent  bacteriologist,  and 
records  must  be  made  of  the  signs  and  symptoms,  so  that  these  may  be 
compared  with  those  in  outbreaks  due  to  the  different  germs. 

Pneumonia  is  a disease  which  causes  many  deaths  in  Michigan  in 
every  year;  and  while  the  State  Board  of  Health  has  done  much  for  the 
education  of  the  people  preparatory  to  its  restriction,  the  Board  has  not 
yet  recommended  isolation  of  patients  as  in  diphtheria,  scarlet  fever,  and 
small-pox.  It  is  anxious  to  collect  all  the  information  it  can  bearing 
upon  the  modes  by  which  pneumonia  is  spread,  in  order  that,  as  soon  as 
practicable,  the  best  measures  may  be  recommended  for  its  restriction. 


2 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


For  the  Restriction  of  Typhoid  Fever. 

The  Board  directed  the  secretary  to  reprint  10,000  copies  of  the  leaflet 
relative  to  the  prevention  of  typhoid  fever,  for  distribution  to  school 
teachers,  and  to  the  neighbors  of  premises  placarded  for  that  disease. 

Scarlet  fever  has  been  greatly  lessened  by  the  people  acting  on  the  advice 
of  the  State  Board  of  Health.  Should  not  that  advice  be  more  generally 
accepted  and  acted  upon? 

Dr.  Baker  read  a paper  with  the  above  title.  The  paper  was  illus- 
trated by  tables  and  a diagram  exhibiting  death-rates  from  scarlet  fever 
in  Chicago,  before  and  since  the  Illinois  State  Board  of  Health  began  to 
labor  for  its  restriction;  also  in  Michigan  before  and  since  such  efforts 
have  been  in  operation;  also  in  one  portion  of  the  State  compared  with 
other  portions  and  with  the  State  as  a whole. 

The  paper  was  ordered  to  be  published  in  t'he  Annual  Report  of  the 
Board  for  1897. 


A Quarter  Century  of  Public-health  Work. 

Dr.  Baker  made  a brief  preliminary  report  relative  to  utilizing  the 
coming  occasion  of  the  completion  of  a quarter  century  of  public-health 
work  in  Michigan  for  the  especial  advancement  of  the  purposes  which 
the  legislature  had  in  view  in  establishing  the  State  Board  of  Health, — 
the  lessening  of  sickness  and  the  prevention  of  deaths. 

A communication  from  Theodore  R.  MacClure,  on  an  allied  subject, 
was  presented  and  acted  upon. 

Formalin  “ Formic  Aldehyde”  as  a Disinfectant. 

Dr.  Baker  asked  the  attention  of  the  Board  to  the  claims  being  made 
for  the  efficiency,  economy,  and  general  usefulness  of  Formic  Aldehyde 
as  a disinfectant.  It  is  obtained  by  partially  burning  methyl  alcohol, 
commonly  called  wood  alcohol,  in  s.uch  manner  as  to  remove  from  it  two 
atoms  of  its  hydrogen.  Formic  Aldehyde  is  said  to  be  a volatile,  rapidly 
diffusing  gas,  having  nearly  the  same  specific  gravity  as  air;  it  is  exceed- 
ingly penetrating  and,  it  is  claimed,  will  destroy  cultures  of  typhoid  fever 
and  of  diphtheria  germs  even  when  they  are  folded  in  mattresses  and  bed- 
ding. It  is  claimed  that  it  is  as  easily  managed  as  the  fumes  of  burning 
sulphur,  and  that  it  has  the  very  great  merit  of  disinfecting  without  the 
destruction,  discoloration  or  decoloration  of  even  the  finest  fabrics.  Dr. 
Baker  thought  it  desirable  that  the  State  Board  of  Health  -take  measures 
to  ascertain  whether  or  not  Formic  Aldehyde  has  advantages  as  a 
disinfectant. 

The  subject  was  referred  to  Prof.  Fall  for  investigation  and  report  to 
the  Board  at  a future  meeting. 

Memorial  to  Michigan  members  of  Congress , relative  to  Senate  Bill  1552  ufor 

the  further  prevention  of  cruelty  to  animals  in  the  District  of  Columbia.” 

The  following  memorial  was  unanimously  adopted  by  the  Board: — 

Whereas,  Senate  Bill  1552,  “For  the  further  prevention  of  cruelty  to  animals  in 
the  District  of  Columbia”  is  now  pending  in  the  United  States  Senate,  and  it  is 
believed  by  this  Board  that  such  a law  would  cause  great  and  lasting  damage  and 
obstruction  to  further  scientific  work  in  this  country; 


ABSTRACT  OF  PROCEEDINGS  JANUARY  8,  1897. 


3 


4-h 
T'  o 


<2*C\  n \ 
O J ! 


Resolved,  That  we,  the  members  of  the  Michigan  State  Board  of  Health,  make 
urgent  appeal  to  our  Senators  and  Representatives  in  Congress,  and  respectfully 
memorialize  them  to  use  vigorous  effort  to  prevent  the  passage  of  Senate  Bill  1552. 

Resolved,  That  the  Secretary  of  this  Board  is  directed  to  transmit  a copy  of  the 
foregoing  preamble  and  resolution  to  each  Michigan  Senator  and  Representative 
in  Congress. 


Memorial  to  Michigan  Members  of  Congress,  Relative  to  a Permanent  Census 
Service  of  the  United  States. 

The  following  memorial  was  unanimously  adopted  : — 

Whereas,  “The  bill  to  provide  for  a permanent  census  service”  reported  to  Con- 
gress by  Hon.  Carroll  D.  Wright,  will  be  of  great  usefulness  to  the  sanitary  service 
of  this  State,  as  follows:— (1)  By  providing  a more  frequent  statement  of  population, 
thereby  affording  a basis  for  reliable  vital  rates  and  a more  accurate  calculation  of 
intercensal  population,  upon  which  such  rates  depend;  (2)  By  providing  means  for 
ascertaining,  for  the  first  time  in  the  history  of  the  census,  a reliable  representative 
death-rate  for  the  State  which  will  be  comparable  with  those  of  other  States  and 
countries — Michigan  being  now  a so-called  non-registration  State;  (3)  If  Michigan 
shall  become  a registration  State  by  act  of  the  present  Legislature  for  the  imme- 
diate registration  of  deaths,  by  providing  an  annual  comparative  compilation  of  its 
data  in  connection  with  those  of  other  registration  States,  thereby  greatly  increas- 
ing the  usefulness  of  the  Michigan  statistics;  therefore  be  it 

Resolved,  That  the  Michigan  State  Board  of  Health,  at  its  quarterly  meeting  held 
at  Lansing,  January  8,  1897,  urgently  recommends  the  passage  of  the  bill  for  a per- 
manent census  service,  on  the  ground  of  the  improvement  that  will  result  therefrom 
to  the  sanitary  interests  of  the  country;  and  therefore, 

Resolved,  That  a copy  of  this  resolution  be  sent  to  each  Senator  and  Representa- 
tive from  Michigan  in  Congress,  with  the  request  that  they  labor  for  the  passage  of 
the  measure. 

Memorial  to  the  Michigan  Legislature  Asking  for  Improvement  in  Existing 
Laws  Relative  to  Registration  of  Vital  Statistics. 

The  following  memorial  was  unanimously  adopted: — 

Whereas,  Under  the  present  system  of  registration  of  vital  statistics,  which  has 
remained  without  alteration  or  improvement  since  1869,  there  is  failure  to  obtain  a 
large  proportion  of  the  births  and  deaths  that  actually  occur  in  the  State,  and  to 
obtain  such  data  as  are  collected  in  time  to  be  of  the  greatest  practical  use  to  the 
work  of  this  Board;  therefore  be  it 

Resolved,  That  the  Michigan  State  Board  of  Health  respectfully  petitions  the 
Michigan  Legislature  to  pass  a law  that  shall  provide  for  the  early  registration  of 
all  deaths  that  occur  in  the  State,  requiring  certificates  of  deaths,  and  making  pro- 
vision for  an  early  publication  of  results  so  that  they  shall  be  available  for  the  use 
of  this  Board  and  of  local  health  officers  in  their  every-day  work  of  restricting  dis- 
eases in  this  State. 


SPECIAL  BIENNIAL  REPORT  OF  THE  STATE  BOARD  OF  HEALTH. 

Relative  to  Public-health  Laws  and  Proposed  Legislation  in  the  Interests  of 

Public  Health. 

To  the  Present  Governor  and  to  the  Incoming  Governor  of  Michigan: — 

Although  not  required  by  the  letter  of  the  law,  public  policy  dictates 
that  the  results  of  the  observations  and  studies  of  the  State  Board  of 
Health,  so  far  as  they  relate  to  imperfections  in  existing  laws  relating  to 
the  public  health,  or  to  proposed  amendments  of  those  laws,  be  placed 
before  the  retiring  Grover  nor  and  incoming  Governor,  to  the  end  that 
in  case  either  of  those  officials  deems  it  best,  convenient  opportunity  may 


4 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


thus  be  afforded  to  bring  to  the  notice  of  the  legislature  any  such 
propositions  which  seem  to  be  for  the  public  good.  Accordingly,  this 
special  report  by  the  State  Board  of  Health  is  respectfully  submitted. 

The  State  Quarantine  Law , — Act  1893 . 

At  the  present  time,  no  unusual  sickness  or  mortality  is  being  experi- 
enced in  Michigan.  None  is  seriously  threatened.  The  State  Quaran- 
tine Law  (Act  47,  Laws  of  1893),  to  enable  the  Governor  and  the  State 
Board  of  Health  to  do  certain  acts  in  an  emergency,  has  been  acted  under 
a few  times  during  the  past  two  years,  with  results  which  have  been  very 
satisfactory  to  this  Board  and  to  the  people  of  threatened  localities. 

Because  of  the  lessened  immigration,  and  because  of  other  conditions, 
no  occasion  has  seemed  to  call  for  such  action,  under  that  law,  as  the 
inspection  of  immigrants  or  travelers  at  the  State  line,  to  keep  out  dan- 
gerous infection.  If  occasion  had  demanded  such  action,  it  is  not  prob- 
able that  it  could  properly  have  been  taken  successfully,  for  the  reason 
that  the  law  is  not  so  framed  as  to  be  useful  for  that  purpose,  the  State 
Supreme  Court  having  decided  (102  Mich.,  page  248)  that  such  rules  as, 
in  the  opinion  of  the  State  Board  of  Health,  are  required  to  make  the  law 
of  use  for  the  purpose  of  excluding  infection  from  entry  into  the  State, 
cannot  be  made  and  enforced  by  the  State  Board  of  Health.  If  the  people 
of  Michigan  wish  to  provide  for  an  emergency  when  they  are  to  rely  upon 
the  State  quarantine  law  to  protect  from  the  danger  of  cholera,  small-pox, 
or  any  other  dangerous  disease  being  brought  into  the  State  by  immi- 
grants or  travelers,  further  legislation  is  necessary. 

As  before  suggested,  that  law  is  very  useful,  from  time  to  time,  for  the 
investigation  of  outbreaks  within  the  State  of  dangerous  diseases  which 
may  threaten  to  spread. 

Some  of  the  reasons  why  the  present  law  (Act  47  of  1893)  is  not  useful, 
for  one  of  the  main  purposes  for  which  it  was  enacted,  are  stated  on 
pages  xcvii-xcviii  of  the  Annual  Report  of  the  State  Board  of  Health  for 
the  year  1894,  and  on  pages  lxxxvi-lxxxvii  of  the  Annual  Report  for  the 
year  1895. 

Proposed  Amendment  of  Law  Relative  to  Vital  Statistics. 

The  law  establishing  the  State  Board  of  Health  says:  “They  shall 
especially  study  the  vital  statistics  of  this  State,  and  endeavor  to  make 
intelligent  and  profitable  use  of  the  collected  records  of  deaths.”  This  has 
been  done,  and  the  statistics  have  been  found  valuable;  but  their  value 
and  usefulness  would  be  very  much  greater  if  the  law  were  so  amended 
that  the  records  were  made  immediately  after  the  occurrence  of  the 
deaths,  instead  of  postponing  the  making  of  the  first  record,  as  is  now 
done,  until  a year  or  more  has  elapsed.  In  his  Annual  Report  on  this 
subject,  the  Secretary  of  State,  under  whose  direction  the  mortality 
statistics  are  collected  and  published,  has  recommended  the  amendment 
of  the  law;  the  chief  of  the  division  of  vital  statistics  has  drawn  a bill 
which  has  been  considered  by  a committee  of  the  State  Medical  Society, 
by  a committee  of  the  State  Conference  of  local  health  officers,  and  by 
a committee  of  the  State  Board  of  Health,  all  of  which  organizations 
have  recommended  the  amendment  of  the  law,  and  it  is  hoped  that  the  law 
may  be  amended  at  this  coming  session  of  the  legislature. 


ABSTRACT  OF  PROCEEDINGS  JANUARY  8,  1897. 


5 


State  Hospital  for  Consumptives. 

Although  consumption  is  now  well  known  to  be  a dangerous  communi- 
cable disease,  and  one  which  among  intelligent  and  well-to-do  people  is 
one  of  the  easiest  diseases  to  restrict — by  the  careful  destruction  of  the 
infectious  sputa — yet  that  disease  still  continues  to  destroy  more  people 
in  Michigan  than  does  any  other  disease.  The  State  Board  of  Health  has 
long  recognized  the  fact  that  it  can  never  be  avoided  by  the  most  intelli 
gent  and  most  conscientious  classes  of  our  people  so  long  as  the  ignorant 
and  poor  people  afflicted  with  that  disease  are  permitted  and  by  circum 
stances  are  forced  to  continue  to  infect  crowded  work  shops,  factories, 
schools  and  public  places.  The  law  requires  cases  of  dangerous  com- 
municable diseases  to  be  reported  to  the  local  health  officer.  An  impor- 
tant question  is  what  shall  be  done  relative  to  those  consumptives,  of  both 
sexes,  who,  when  reported,  are  found  at  that  stage  of  most  danger  of 
spreading  the  disease,  whom  circumstances  require  to  continue  to  labor, 
and  who  have  not  been  taught  and  who  cannot  easily  be  taught  how  to 
avoid  spreading  this  most  fatal  disease  to  others? 

Previous  to  the  last  session  of  the  legislature,  the  State  Board  of  Health 
had  given  this  subject  much  consideration.  It  was  considered  by  the 
State  Conference  of  local  and  State  health  officials,  at  Ann  Arbor  in 
181)1,  and  resolutions  unanimously  adopted  as  follows  : — 

“Resolved,  That  it  is  the  judgment  of  this  Conference  of  Health  Officers  and  other 
delegates  of  Michigan  Boards  of  Health,  that  consumption  (and  other  diseases  due 
to  the  Bacillus  tuberculosis)  should  be  included  in  the  list  of  ‘Diseases  dangerous  to 
the  public  health,’  referred  to  in  Secs.  1675  and  1676  Howell's  Statutes,  requiring 
notice  by  householders  and  physicians  to  the  local  health  officer,. as  soon  as  such  a 
disease  is  recognized. 

“ Resolved , That  we  recognize  the  following  facts: 

“1.  That  tuberculosis  is  the  most  grave  and  fatal  disease  now  affecting  the  health 
and  lives  of  the  people  of  this  State,  destroying  about  three  thousand  lives  per  year; 

“2.  That  this  disease  originates  principally  by  transmission  from  man  to  man  or 
from  man  to  animals  and  again  to  man; 

“3.  That  the  spread  of  this  disease  can  be  best  arrested  by  the  disinfection  of  the 
sputa  and  other  discharges,  by  special  supervision  of  those  infected,  and  by  the  care 
of  such  persons  under  conditions  which  will  prevent  the  transmission  of  the  disease 
to  others; 

“4.  That  such  disinfection  and  supervision  cannot  be  carried  out  in  the  crowded 
houses  of  the  poorer  classes;  and 

“5.  That,  under  conditions  which  will  prevent  reinfection,  many  consumptives 
may  be  permanently  cured,  and  return  to  their  homes  and  work,  educated  in  the 
methods  of  restricting  The  disease.  In  view  of  these  facts; 

“ Resolved , That  this  Conference,  by  its  officers,  respectfully  memorialize  the  next 
Legislature  for  an  appropriation  sufficient  for  the  purpose  of  building,  equipping 
and  maintaining  a State  Hospital  for  Consumptives. 

“Resolved,  That  the  planning,  construction  and  equipping  of  the  State  Hospital 
for  Consumptives  may  well  be  entrusted  to  the  State  Board  of  Health. 

“ Resolved , That  the  location  of  the  Hospital  should  be  such  that  it  may  be  accessi- 
ble by  railroad  to  the  thickly-settled  parts  of  the  State,  and  such  as  to  permit  of  out- 
door exercise  and  light  out-door  labor  whenever  the  weather  will  permit. 

“Resolved,  That  although  consumption  is  the  most  dangerous  communicable  dis- 
ease, a hospital  can  be  so  planned,  equipped  and  managed  as  that  it  shall  not 
seriously  endanger  the  neighboring  inhabitants;  and  as  it  is  desirable  that  it  shall 
contribute  the  largest  amount  of  sanitary  education  to  the  teachers  and  to  the  peo- 
ple of  the  State,  therefore, 

“Resolved,  That  it  is  the  judgment  of  this  Conference  that  the  proposed  State  Hos- 
pital for  Consumptives  should  be  located  at  the  seat  of  the  State  University  at  Ann 
Arbor,  in  order  that  it  may  afford  the  best  opportunities  for  the  observation  and 
study  of  this  most  important  disease,  in  conjunction  with  the  investigations  now 


6 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


being  so  satisfactorily  pursued  in  bacteriology  and  other  departments  of  sanitary 
science,  at  the  State  Laboratory  of  Hygiene. 

“ Resolved , That  this  Conference  hereby  respectfully  memorializes  the  Legislature 
of  Michigan  at  its  next  session  to  take  such  action  as  will  result  in  a knowledge  of 
the  extent  to  which  the  dairy  cattle  and  other  animals  supplying  milk,  meat  or  other 
food  products  to  the  people  of  Michigan  are  infected  with  tuberculosis.  Also  that  it 
take  such  action  as  will  tend  to  stop  the  spreading  of  tuberculosis  among  animals, 
and  from  animals  to  man.” 

Pursuant  to  this  action,  the  State  Board  of  Health  carefully  prepared 
a bill  to  establish  a State  Hospital  for  Consumptives,  and  the  bill  was 
introduced  into  both  houses  of  the  legislature,  it  being  “Senate  bill  433” 
and  “House  bill  828.”  Neither  of  these  bills  was  given  any  consideration 
whatever  by  the  legislature.  A copy  of  the  bill  is  printed  on  pages 
xxviii-xxx  of  the  Annual  Report  of  the  State  Board  of  Health  for  1895. 

The  question  which  the  State  Board  of  Health  wishes  to  have  placed 
before  the  present  legislature  is:  Is  general  poverty  and  “hard  times” 
a valid  reason  for  not  considering  a plan  designed  to  lessen,  among  the 
people  generally,  one  of  the  most  common  causes  of  poverty  and  “hard 
times,”  namely  that  most  general  disease  which  causes  most  deaths  and 
most  prolonged  and  expensive  sickness  and  disability  for  productive 
labor? 


The  Regulation  of  the  Practice  of  Medicine. 

At  the  present  time,  any  person  taken  suddenly  too  ill  to  dictate  what 
physic  ian  shall  be  employed,  is  liable  to  be  placed  in  the  care  of  some  pre- 
tender who  holds  himself  out  as  a physician.  When  able  to  select  a 
physician,  people  generally  have  no  way  whereby  they  can  well  judge 
of  the  extent  of  the  education  and  skill  of  those  who  appear  to  be 
physicians.  Lawyers  are  not  permitted  to  take  charge  of  the  legal  inter- 
ests of  the  people,  which,  usually,  relate  only  to  pecuniary  affairs, 
except  that  they  shall  first  pass  an  examination  tending  to  show  them  to 
be  qualified  for  such  duties.  Physicians  deal  always  with  the  interests  of 
life  and  health;  yet  in  Michigan  the  legislature  has  mot  provided  for 
guarding  those  great  interests  as  well  as  it  has  those  interests  connected 
with  legal  controversies. 

Recently  systematic  effort  has  been  made  by  so-called  medical  colleges 
in  adjoining  States  to  induce  persons  in  Michigan  to  purchase  diplomas, 
so  that  they  may  register  as  physicians  under  the  present  very  imperfect 
law.  Numbers  of  persons  who  were  not  qualified  to  practice  medicine 
have  applied  to  the  county  clerks,  and  in  some  instances  have  been  per- 
mitted to  register  and  enter  upon  practice  as  physicians,  upon  the  claim 
that  they  were  entitled  to  do  so  because  of  such  diplomas  purchased 
without  their  having  attended  any  medical  college. 

The  public  health  suffers,  in  many  ways,  through  the  ignorance  of  those 
who  assume  to. practice  medicine:  (1)  The  health  and  life  of  persons  who 
come  under  the  care  of  unqualified  physicians  are  endangered  by  their 
ignorance.  (2)  Dangerous  communicable  diseases  occur  in  their  practice, 
and  such  doctors  fail  to  recognize  and  report  them  to  the  local  health 
officer,  the  disease  is  not  restricted,  and  unnecessary  sickness  and  loss  of 
life  results.  (3)  Such  medical  practitioners  do  not  realize  the  impor- 
tance of  many  of  the  subjects  on  which  the  State  Board  of  Health  advises 
the  people,  consequently  they  fail  to  cooperate  for  the  restriction  and 


ABSTRACT  OF  PROCEEDINGS  JANUARY  8,  1897. 


7 


prevention  of  diseases.  (4)  Some  of  these  unqualified  persons  are  chosen 
as  health  officers,  and  thus  the  health  interests  of  whole  communities 
are  jeopardized. 

The  present  law — Act  167  of  1883,  as  amended  by  Act  268  of  1887 — 
permits  any  person  to  practice  medicine  in  Michigan  who  is  a “graduate 
of  any  legally  authorized  medical  college  in  this  State  or  any  (one)  of 
the  United  States,  or  in  any  other  country.”  As  medical  colleges  located 
in  adjoining  States  and  claiming  to  be  “legally  authorized”  advertise 
extensively  in  Michigan,  and  thus  induce  many  unqualified  persons  to 
purchase  diplomas  without  attendance  at  such  “colleges,”  the  law  is  not 
a sufficient  protection.  Another  serious  defect  in  the  law  is  that  it  leaves 
with  the  several  county  clerks  the  decision  of  who  are  graduates  of 
legally-authorized  medical  colleges,  and  these  officers  are  unable  to  obtain 
the  necessary  information. 

The  law  should  be  amended  so  as  to  require  one  State  commission  or 
. board  with  a central  office  at  the  State  Capitol  to  collect  the  facts  which 
will  make  it  possible  to  decide  not  only  who  are  graduates  of  legally 
authorized  medical  colleges,  but  also  who  are  properly  qualified  to  be 
entrusted  with  the  health  and  lives  of  citizens  of  Michigan.  The  law 
should  not  permit  the  registration  of  any  physician  except  after  examina- 
tion of  the  physician,  or  of  his  diploma  and  positive  knowledge  of  the 
standing  of  the  medical  college  which  granted  his  diploma. 

It  is  probable  that  the  philanthropic  medical  profession  of  the  State 
would  willingly  contribute,  as  re-registration  fees,  sufficient  money  to 
carry  out  the  provisions  of  a good  law  on  this  subject.  Or  those  hereafter 
admitted  to  practice  may  be  made  to  meet  the  expenses.  But  in  the 
opinion  of  this  Board  this  subject  is  of  sufficient  importance  to  the  people 
of  the  State  to  warrant  the  expenditure  of  the  public  money  necessary  to 
secure  protection  from  the  present  evils. 

It  is  the  belief  of  the  State  Board  of  Health  that  the  supervision  of  the 
registration  of  physicians  should  not  be  required  of  the  State  Board  of 
Health,  whose  members  are  and  should  be  selected  for  important  duties 
requiring  knowledge,  experience  and  studies  in  sanitary  science,  public- 
health  administration,  and  the  prevention  of  sickness  and  deaths,  quali- 
fications very  different  from  those  required  in  judging  of  the  qualifications 
of  physicians  for  the  cure  of  disease,  or  for  the  surgical  treatment  of 
maladies  and  injuries. 

There  should  be  a State  Medical  and  Surgical  Board,  appointed  by  the 
Oovemor  and  Senate,  having  its  office  at  the  Capitol,  and  having  at  least 
one  paid  official  constantly  on  duty.  Money  losses  will  thus  be  prevented 
more  than  sufficient  to  meet  the  expense;  and  life  and  health  in  Michigan 
will  be  more  secure. 

For  the  Restriction  and  Prevention  of  Disease , Educational  Work , to  Secure 
the  Co-operation  of  the  People , is  Necessary. 

Experience  has  proved  that  for  the  successful  restriction  or  prevention 
of  the  dangerous  diseases,  the  cooperation  of  the  people  themselves  is 
requisite,  and  the  people  themselves  must  know  what  diseases  are  com- 
municable, how  they  are  spread,  and  the  best  measures  for  their  restric- 
tion. For  many  years,  the  State  Board  of  Health  has  systematically  aided 


8 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


local  health  officials  to  restrict  dangerous  diseases,  by  supplying  to  the 
neighbors  of  the  infected  premises  information  necessary  to  enable  them 
to  cooperate  with  the  local  health  officers.  The  official  reports  to  the  State 
Board  of  Health,  and  the  mortality  statistics  collected  and  published  by 
the  Secretary  of  State  agree  in  proving  that  there  has  been  a very  great 
saving  of  human  life  in  Michigan  while  this  work  has  been  done,  compared 
with  the  death-rates  when  it  was  not  being  done.  The  evidence  is  that 
more  than  a thousand  lives  per  year  have  been  saved,  and  thousands  of 
cases  of  sickness  avoided,  involving  a saving  to  the  people  of  this  State  of 
money  values  exceeding  a million  dollars  per  year.  This  work  by  the 
State  Board  of  Health  has  grown,  more  diseases  are  dealt  with  than, 
formerly,  and  the  appropriations  for  the  use  of  the  Board  are  now  inade- 
quate to  do  the  work. 

Another  method  of  education  of  the  people  for  their  cooperation  in 
public-health  work  has  been  by  means  of  the  Sanitary  Conventions  for 
which,  together  with  several  other  purposes,  a small  annual  appropriation 
($2,000  per  year)  has  been  made.  The  other  purposes  specified  in  the  law 
have  so  encroached  on  the  fund  as  to  leave  very  little  for  the  Sanitary 
Conventions,  and  this  Board  deems  it  for  the  public  good  that  more  such 
conventions  be  held  than  it  has  been  found  possible  to  hold  heretofore. 

The  legislature  in  1895,  by  Act  146,  required  the  State  Board  of  Health 
to  send  to  all  school  teachers  in  the  State  data  and  statements  to  enable 
them  to  teach  the  modes  of  spreading  and  the  best  means  of  restricting 
the  dangerous  communicable  diseases.  No  appropriation  has  been  made 
for  this  additional  work.  This  Board  considers  this  law  to  be  of  the 
utmost  importance,  and  for  the  first  year  complied  with  it  as  fully  as  pos- 
sible, In  doing  so,  however,  no  money  was  left  with  which  to  meet  the 
expenses  oif  the  Sanitary  Conventions,  and  of  other  lines  of  work  required 
of  the  Board. 

The  State  Board  of  Health  believes  that  the  best  interests  of  the  people 
will  be  subserved  by  the  making  of  a small  appropriation,  not  exceeding 
ten  thousand  dollars  per  annum,  for  the  general  purposes  for  which  the 
board  exists,  including  the  fulfillment  of  Act  146  of  1895,  and  other  laws. 

It  seems  certain  that  the  appropriations  already  made  for  and  used  by 
the  Board  have  been  returned  to  the  people  many  fold,  in  money  values 
saved.  It  is  believed  that  the  additional  appropriation  here  asked  for  will* 
yield  equally  valuable  returns. 


ABSTRACT  0F‘  PROCEEDINGS  JANUARY  8,  1897. 


9 


SECRETARY’S  REPORT  OF  DANGEROUS  COMMUNICABLE  DISEASES,  OF  WORK 
DONE  IN  THE  OFFICE  OF  THE  STATE  BOARD  OF  HEALTH,  AND  OF 
THE  CONDITION  OF  HEALTH  GENERALLY  IN  MICHIGAN 
DURING  THE  QUARTER  ENDING 
DECEMBER  81,  1898. 

Dangerous  Communicable  Diseases. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  diseases  in  Michi 
gan,  received  from  all  sources  and  filed,  and  the  corresponding  number  concerning 
which  action  was  taken  by  this  office,  during  the  quarter,  are  as  follows:  For  diph- 
theria, 144;  for  scarlet  fever,  102;  for  typhoid  and  typho-malarial  fever,  156;  for 
measles,  62;  for  whooping-cough,  45;  and  for  consumption,  41.  Total  for  the  six 
diseases,  550. 

The  number  of  communications  relative  to  dangerous  communicable  diseases, 
received  and  placed  on  file  during  the  quarter,  was  2,966. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and  demands 
for  weekly  and  final  reports  on  cards,  or  in  the  form  of  the  circular  letter,  were 
sent  out  during  the  quarter  to  the  number  of  2,188. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  quarter  were:  For 
diphtheria,  91;  scarlet  fever,  73;  typhoid  and  typho-malarial  fever,  188;  measles,  41; 
whooping-cough,  39;  consumption,  35.  Total  for  the  six  diseases,  467. 

During  the  quarter,  the  local  columns  of  1,929  newspapers,  have  been  looked  over 
for  reports  of  occurrence  of  communicable  diseases.  (This  work  is  done  by  the 
clerk  who  acts  as  messenger  and  janitor,  in  the  intervals  of  his  performance  of 
other  duties.)  This  has  resulted  in  giving  this  office  first  information  of  the  alleged 
occurrence  of  5 outbreaks  of  diphtheria,  4 outbreaks  of  scarlet  fever,  26  outbreaks 
of  typhoid  and  typho-malarial  fever,  7 outbreaks  of  measles,  5 outbreaks  of  whoop- 
ing-cough, and  7 cases  of  consumption.  To  what  extent  the  reports  of  these  alleged 
outbreaks  were  verified,  is  shown  in  the  accompanying  table: 


TABLE  I. — Fourth  Quarter  of  1896. — Exhibiting  the  number  of  outbreaks  of  Diph 
theria , Scarlet  Fever , Typhoid  Fever , Measles,  Whooping-cough,  and  Consumption 
from  October  1 , to  December  31,  1896,  of  which  notice  was  received  at  the  office  of 
the  Michigan  State  Board  of  Health ; the  per  cent  of  reports,  first  information  con- 
cerning which  was  received  through  the  newspapers ; the  per  cent  of  newspaper 
reports  which  were  confirmed  by  the  health  officer;  the  per  cent  of  reports  which 
were  denied  by  the  health  officer;  and  the  per  cent  relative  to  which  no  reply  was 
received  from  the  health  officer. 


Diseases. 

Reports  from 
all  sources, 
Oct.  1,  to  Dec. 
31, 1896. 

Per  cent  of 
all  reports  which 
were  obtained 
from  the  news- 
papers. 

Per  cent 
of  newspaper 
report^  which 
were  confirmed 
by  the  health 
officer. 

Per  cent 
of  newspaper 
reports  which 
were  denied  by 
the  health 
officer. 

Per  cent 
of  newspaper 
reports  to  which 
the  health  offi- 
cer made  no 
reply  to  no- 
tice sent 
from  this 
office. 

Diphtheria 

144 

3 

40 

40 

20 

Scarlet  fever 

102 

4 

75 

0 

25 

Typhoid  fever . . . 

156 

17 

58 

42 

0 

Measles 

62 

11 

43 

29 

28 

Whooping-cough 

45 

11 

40 

40 

20 

Consumption 

41 

17 

43 

14 

43 

Average  for  the 
six  diseases  ... 

10 

52 

33 

15 

i 

2 


10 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Summary  Relative  to  the  Year , 1896. 

The  number  of  reports  of  outbreaks  of  dangerous  communicable  diseases  in 
Michigan,  received  from  all  sources  and  filed,  and  the  corresponding  number  con- 
cerning which  action  was  taken  by  this  office,  during  the  year  1896,  are  as  follows: 
For  diphtheria,  419;  for  scarlet  fever,  385;  for  typhoid  and  typho-malarial  fever,  563; 
for  measles,  310;  for  whooping-cough,  218;  for  consumption,  316;  and  for  small-pox, 
8.  Total  for  the  seven  diseases,  2,219. 

Not  including  telephone  and  verbal  messages,  the  number  of  communications  rela- 
tive to  dangerous  communicable  diseases,  received  and  placed  on  file  during  the 
year,  was  10,012. 

Relative  to  dangerous  communicable  diseases,  letters,  written  cards,  and  demands 
for  weekly  and  final  reports  on  cards,  or  in  the  form  of  the  circular  letter,  were 
sent  out  during  the  year  to  the  number  of  7,619. 

The  “final”  reports  of  outbreaks  received  and  filed  during  the  year  1896,  were: 
For  diphtheria,  328;  scarlet  fever,  321;  typhoid  and  typho-malarial  fever,  491; 
measles,  224;  whooping-cough,  119;  consumption,  128;  small-pox,  8.  Total  for  fee 
seven  diseases,  1,619. 

During  the  year  1896,  the  local  columns  of  6,571  newspapers  have  been  looked 
over  for  reports  of  occurrences  of  communicable  diseases.  (This  work  is  done  by 
the  clerk  who  acts  as  messenger  and  janitor,  in  the  intervals  of  his  performance  of 
other  duties.)  This  has  resulted  in  giving  this  office  first  information  of  the  alleged 
occurrence  of  27  outbreaks  of  diphtheria,  14  outbreaks  of  scarlet  fever,  86  outbreaks 
of  typhoid  and  typho-malarial  fever,  32  outbreaks  of  measles,  36  outbreaks  of 
whooping-cough,  1 outbreak  of  small-pox,  and  70  cases  of  consumption.  To  what 
extent  the  reports  of  these  alleged  outbreaks  were  verified,  is  shown  in  the  accom- 
panying table: 


Table  II. — Year  1896. — Exhibiting  the  number  of  outbreaks  of  Diphtheria , Scarlet 
F ver,  Typhoid  Fever,  Measles,  Whooping-cough,  Small-pox  and  Consumption , from 
January  1 to  December  31,  1896,  of  which  notice  was  received  at  the  office  of  the 
Michigan  State  Board  of  Health ; the  per  cent  of  reports,  first  information  concern- 
ing which  was  received  through  the  newspapers ; the  per  cent  of  newspaper  reports 
which  were  confirmed  by  the  health  officer;  the  per  cent  of  reports  which  were 
denied  by  the  health  officer;  and  the  percent  relative  to  which  no  reply  was  received 
from  the  health  officer. 


Diseases 

Reports  from 
all  sources, 
Jan.  1 t Dec. 
31, 1896. 

Per  cent  of 
all  reports  which 
were  obtained 
from  the  news- 
papers. 

Per  cent 
of  newspaper 
reports  which 
were  confirmed 
by  the  health 
officer. 

Per  cent 
of  newspaper 
reports  which 
were  denied  by 
the  health 
officer. 

Per  cent  of 
newspaper  re- 
ports to  which 
the  hea  th 
officer  made 
no  reply 
to  notice  sent 
from  this 
office. 

Diphtheria 

*419 

6 

48 

37 

15 

Scarlet  fever 

*385 

4 

50 

29 

21 

Typhoid  fever... 

*563 

15 

48 

47 

5 

Measles 

*310 

10 

53 

38 

9 

W hooping-cough 

*218 

17 

50 

42 

8 

Consumption 

*316 

22 

56 

23 

21 

Small-pox 

*8 

13 

100 

0 

0 

Average  for  the 
seven  diseases 

12 

51 

37 

12 

* The  numbers  of  outbreaks  given  in  this  table  do  not  necessarily  agree  with  the  numbers  given  in 
tables  in  another  part  of  the  Annual  Report,  for  the  reason  that  all  alleged  outbreaks,  of  which  infor- 
mation was  obtained  from  the  newspapers  and  other  sources  are  included  in  this  table.  If  the  health 
officers  denied  that  such  outbreaks  occurred,  or  if  they  make  no  response  to  the  letters  sent  from  this 
office,  relative  to  newspaper  reports,  such  alleged  outbreaks  are  not  included  in  the  compilation  of  that 
disease. 


ABSTRACT  OF  PROCEEDINGS  JANUARY  8,  1897. 


II 


For  the  purpose  of  facilitating  the  proper  action  for  the  restriction  of  every  “dis- 
ease dangerous  to  the  public  health,”  and  to  make  it  possible  to  compile  the  impor- 
tant “contagious-disease  statistics,”  a record  is  kept  of  facts  concerning  every  out- 
break of  a “disease  dangerous  to  tile  public  health”  upon  which  action  is  taken  by 
this  office,  and  also  of  every  important  communication  relating  thereto  received  or 
sent  out.  This  required  over  17,631  entries  to  be  made  in  the  “Record  Books,”  one 
of  which  books  is  kept  for  each  dangerous  communicable  disease. 

During  the  year  1896,  compared  with  the  year  1895,  action  was  taken  on  out- 
breaks of  dangerous  communicable  diseases  as  follows:  On  diphtheria,  8 outbreaks 
more;  scarlet  fever,  144  outbreaks  less;  typhoid  and  typho-malarial  fever,  70  out- 
breaks less;  measles,  134  outbreaks  more;  whooping-cough,  141  outbreaks  more; 
small-pox,  17  outbreaks  less;  and  consumption,  7 outbreaks  more  than  in  1895.  In 
all,  56  outbreaks  more  were  acted  upon  in  1896  than  in  1895,  and  124  outbreaks  more 
in  1895  than  in  1894;  but  an  accurate  comparison  cannot  easily  be  made,  for  the 
reason  that  no  action  was  taken  relative  to  whooping-cough,  until  July  1,  1895. 

Small  pox  in  Michigan  During  the  Year  1896. 

At  the  beginning  of  the  year  small-pox  was  still  present  in  Detroit.  Eight  new 
outbreaks  of  small-pox  were  reported  during  the  year.  These  were  in  Riga  town- 
ship, Lenawee  Co.;  Imlay  township,  Lapeer  Co.;  Saginaw  city;  Ionia  city;  Green- 
bush  township,  Clinton  Co.;  Burlington  township,  Lapeer  Co.;  Marine  City  and 
Bay  City.  The  outbreak  reported  at  Greenbush  township  was  afterwards  reported 
as  measles.  Final  reports  have  been  received  from  each  of  the  remaining  seven 
outbreaks.  These  final  reports  show  that  outside  of  Detroit,  there  have  occurred  in 
the  State,  during  the  year  1896,  16  cases  and  2 deaths,  and  that  in  every  one  of  the 
seven  outbreaks  the  infection  was  restricted  to  the  one  house  in  which  it  first 
occurred. 

Every  one  of  those  outbreaks  was  due  directly  or  indirectly  to  infection  spread 
from  Detroit.  The  outbreak  which  began  in  Detroit  in  May,  1894,  was  reported 
closed  during  the  week  ending  March  28,  1896,  but  for  the  week  ending  April  18, 
1 new  case  was  reported  which  died.  During  the  year  1896  there  have  occurred  in 
the  city  of  Detroit  21  new  cases  and  14  deaths;  this,  with  the  2 cases  which  were 
still  sick  at  the  close  of  the  year  1895,  make  a total  of  23  cases  and  14  deaths  in  the 
city  of  Detroit  during  the  year  1896.  (From  the  beginning  of  the  outbreak  in  May, 
1894,  until  its  ending  in  April,  1896,  there  occurred  in  the  city  of  Detroit  298  cases 
and  85  deaths.] 

Since  April  18,  1896,  up  to  the  close  of  the  year  1896,  the  State  is  believed  to  have 
been  entirely  free  from  small-pox. 

Compiling,  Editing,  Proof-reading , Printing,  Etc.,  Fourth  Quarter  of  1896. 

The  compilation  of  “Diphtheria  in  Michigan  in  1895”  has  been  finished  and  proved. 
The  compilation  of  reports,  letters,  etc.,  from  all  sources  relative  to  “Scarlet  Fever 
in  Michigan  in  1895”  has  been  made  and  proved.  The  compilation  relative  to 
“Typhoid  Fever  in  Michigan  in  1895”  is  nearly  finished  and  proved  as  far  as 
completed.  Compilations  of  material  relative  to  “Nuisances  in  Michigan  in  1895” 
and  relative  to  “Injuries  and  Loss  of  Life  and  Property  from  Kerosene  and 
Gasoline  in  Michigan  in  1895”  have  been  made. 

The  article  on  “Typhoid  Fever  in  Michigan  in  1894”  has  been  completed.  Short 
articles  relative  to  Measles,  Consumption,  and  Small-pox  in  Michigan  in  1894  have 
been  made  ready  for  the  printer. 

Considerable  work  lias  been  done  in  connection  with  the  introduction  or  sum- 
mary of  the  Communicable-Diseases  articles  for  the  Annual  Report  for  1895.  The 
statement  is  a summary  relative  to  some  of  the  pecuniary  results  of  the  Board’s 
efforts  in  the  saving  of  life  and  the  prevention  of  sickness.  This  summary  has  been 
reprinted  in  pamphlet  form  for  distribution.  It  is  reprint  No.  472.  It  was  sent  to 
members  of  the  Legislature  and  to  editors  of  newspapers;  many  newspapers  pub- 
lished a notice  of  it;  one  such  notice,  in  the  State  Republican,  November  25,  1896, 
is  reproduced  further  on  in  this  report. 

The  index  for  the  Report  for  1895  has  been  completed,  and  the  printing  of  it  will 
immediately  commence. 


12 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


For  the  Report  for  1896,  but  relating  to  the  year  1895,  articles  have  been  prepared 
on  subjects  as  follows:  Rabies,  chicken-pox,  puerperal  fever,  lump-jaw,  tetanus, 
cholera  infantum,  danger  from  careless  dog  poisoning,  diseased  meat  and  milk, 
tuberculosis  in  cattle,  glanders,  disease  in  hogs,  syphilitic  ozena. 

The  preparation  of  copy  for  the  Annual  Report  for  1896  is  well  under  way  to 
completion.  It  is  hoped  that  during  the  next  quarter  the  Report  will  be  printed. 
More  than  half  of  the  copy  is  now  practically  ready  for  the  printer. 

The  article  “Time  of  Greatest  Prevalence  of  Each  Disease  in  Michigan  in  1895“ 
has  been  well  commenced. 

The  article  relative  to  “Meteorology  in  Michigan  in  1895“  is  nearly  completed  and 
ready  for  the  printer. 

The  copy  for  the  “First  Part”  of  the  annual  report  of  the  Secretary  for  the  fiscal 
year  ending  June  30,  1S96,  has  been  completed  and  a portion  of  it  has  been  sent  to 
the  printer. 

Proof  has  been  read  and  an  immense  amount  of  printing  has  been  done  during 
this  quarter.  Over  450  pages  of  the  Annual  Report  for  1895  have  been  printed.  The 
Report  is  all  completed  with  the  exception  of  printing  the  index  and  binding  the 
volume. 


Work  on  Meteorology. 

The  regular  tri-daily  meteorological  observations  have  been  continued  at  this 
station,  and  a summary  for  each  week  and  month  during  the  quarter  has  been 
made  for  use  in  this  office  in  connection  with  sickness  statistics.  The  monthly  sum- 
mary has  been  sent,  at  the  end  of  each  month,  to  the  director  of  the  Michigan  State 
Weather  Service,  at  Lansing,  for  his  use;  it  is  then  sent  by  him  to  the  chief  of  the 
U.  S.  Weather  Bureau,  at  Washington,  D.  C. 

The  regular  yearly  supply  of  meteorological  material,  consisting  of  blank  regis- 
ters, blanks  for  measurements  of  ground-water,  stamped  envelopes,  blank  postal 
cards,  was  sent  to  each  of  18  meteorological  observers;  there  was  also  sent  to  13 
observers  a supply  of  ozone  test-paper  sufficient  to  last  three  months. 

The  following  maps  and  diagrams  have  been  made  to  illustrate  the  Annual  Report 
of  this  Board: 

Map — Movements  of  Contagion  of  Typhoid  Fever  in  Michigan  in  1894. 

Map — Distribution  of  Typhoid  Fever  in  Michigan  in  1894. 

Map— Movements  of  Contagium  of  Small-pox  in  Michigan  in  1894. 

Map — Movements  of  Contagium  of  Measles  in  Michigan  in  1894. 

Map — Distribution  of  Measles  in  Michigan  in  1894. 

Diagram — Decreasing  Death-rate  in  Michigan  from  Scarlet  Fever  per  10,000  inhab- 
itants. 

Diagram — Increasing  Life  Saving  in  Michigan,  from  Scarlet  Fever,  per  10,000 
inhabitants. 

Diagram— Reported  Deaths  from  Small-pox  in  Michigan,  during  eacb  of  the  26 
years,  1869-94. 

Diagram — Decreasing  Death-rate  in  Michigan,  from  Small-pox,  per  10,000  inhab- 
itants. 

Diagram — Increasing  Life  Saving  in  Michigan,  from  Small-pox,  per  10,000  inhab- 
itants. 

Diagram — Typhoid  Fever  in  Duncan  Township,  Michigan. 

Diagram — Isolation  and  Disinfection  Restricted  Typhoid  Fever  in  Michigan  in 
1894. 

Diagram — Decreasing  Death-rate  in  Michigan,  from  Typhoid  Fever,  per  10,000 
inhabitants. 

Diagram— Reported  Deaths  in  Michigan  from  Typhoid  Fever  for  each  of  the  27 
years,  1868-94. 

Diagram— Isolation  and  Disinfection  Restricted  Measles  in  1894. 

Diagram — Alleged  Nuisance  in  Colon  Township,  St.  Joseph  Co.,  Michigan. 

Diagrams  1,  2,  3,  4,  5,  6— Average  Temperature,  Average  Daily  Range  of  Tempera- 
ture, Absolute  and  Relative  Humidity,  Fogs  and  Rainfall,  relating  to  conditions  in 
Michigan  during  the  year  1895. 

Meteorological  registers  from  11  stations  have  been  received  and  examined  for 
errors,  and  computations  of  the  registers  from  these  stations  for  the  months  of 
September,  October,  and  November,  1896,  have  been  made. 


ABSTRACT  OF  PROCEEDINGS  JANUARY  8,  1897. 


13 


Accessions  to  the  Library , Card-Cataloguing,  Etc. 

About  75  books  and  pamphlets,  and  some  300  numbers  of  journals  (weeklies, 
monthlies  and  quarterlies)  have  been  received,  mostly  in  exchange  for  our  publica- 
tions, and  entered  in  the  library  accession  book. 

Considerable  work  has  been  done  in  card-cataloguing  the  library: 

Work  in  keeping  the  financial  accounts  of  the  office  has  been  continued. 

Hektograph  Work. 

Hektograph  work  to  the  amount  of  about  2,930  pages  has  been  prepared,  includ- 
ing 1,140  pages  of  weekly  and  monthly  bulletin  “Health  in  Michigan;”  408  pages  of 
proceedings  of  regular  and  special  meetings;  pages  of  a “Special  Biennial  Report 
of  the  State  Board  of  Health  to  the  present  and  incoming  Governors;”  100  pages 
relative  to  examination  of  plans  and  specifications  for  proposed  public  buildings; 
277  pages  relative  to  delinquent  card  reports,  etc. 

Educational  Leaflets  to  School  Teachers,  etc. 

To  teachers  and  others,  there  have  been  sent  some  2,166  copies  of  the  four-page 
leaflet  No.  226;  900  copies  of  the  leaflet  No.  227;  and  about  742  sets  of  the  several 
different  leaflet  publications  of  this  office  bearing  upon  the  subject  of  teaching  in 
the  schools  the  modes  of  spreading  and  the  best  methods  for  the  restriction  and 
prevention  of  the  dangerous  communicable  diseases. 

Of  the  above-mentioned  2,166  copies  of  the  leaflet  No.  226,  about  900  copies  were 
distributed  to  teachers  and  others  during  the  meeting  of  the  State  Teacher’s  Asso- 
ciation, at  Lansing,  December  28-30,  1896. 

For  the  lack  of  available  appropriation,  the  distribution  of  the  Board’s  publica- 
tions to  this  class  of  public-health  workers  has  been  necessarily  small;  mainly  to 
teachers  and  others  who  applied  for  them. 

State  Teachers’  Association,  Lansing,  Dec.  28-30,  1896. 

At  the  meeting  of  this  association  a paper  on  “School  Hygiene”  was  read  by  Prof. 
W.  E.  Conkling,  of  Dowagiac,  and  discussed  by  Prof.  J.  L.  Wagner,  of  Charlotte. 
Before  the  College  section  of  the  association,  a paper  was  read  by  Prof.  Delos  Fall, 
Albion  College,  member  of  the  State  Board  of  Health,  on  “A  College  Course  in  Sani- 
tary Science.”  This  paper  was  followed  by  an  address  by  Prof.  Victor  C.  Vaughan. 
M.  D.,  of  the  University  of  Michigan,  and  the  subject  was  discussed  by  others. 

To  facilitate  the  teaching  of  sanitary  science  in  colleges  and  high  schools,  Prof. 
Fail  has  made  a list  of  publications  of  the  Michigan  State  Board  of  Health,  arranged 
in  order  to  serve  as  data  for  a college  or  high-school  course  in  sanitary  science.  This 
list  and  the  publications  mentioned  therein  have  been  sent  to  Prof.  Montgomery,  at 
Olivet  College,  and  Prof.  Sloan,  at  Hillsdale  College,  since  the  meeting  of  the  State 
Teachers’  Association.  It  is  understood  that  the  subject  will  be  taught  at  both  of 
these  colleges.  Other  colleges  and  high  schools  might  receive  the  publications,  but 
probably  not  all  such  schools  could  be  supplied  with  all  of  the  publications. 

Annual  Reports  from  Health  Officers  for  the  Year  1896. 

Work  has  been  done  to  prepare  for  securing  the  annual  reports  from  health  offi- 
cers. Two  blanks  and  a circular  letter  have  been  made  ready,  and  envelopes  to  the 
number  of  1,584  have  been  addressed  to  health  officers  of  townships,  cities  and  vil- 
lages. Each  envelope  contains  one  circular  letter  No.  218,  one  copy  of  blank  “I,” 
and  one  blank  form  “Copy  of  Record”  of  diseases  dangerous  to  the  public  health  in 
1896.  These  supplies  will  be  sent  out  during  the  first  week  in  January,  1897. 

General  Distribution  of  Leaflets,  Diagrams,  Etc. 

About  the  usual  numbers  of  pamphlets  on  the  restriction  and  prevention  of  the 
dangerous  communicable  diseases  were  sent  to  health  officers  of  localities  in  which 
dangerous  diseases  have  been  reported.  It  was  at  the  same  time  requested  of  those 


14 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


health  officers  that  the  pamphlets  be  distributed  to  the  neighbors  of  the  persons  sick 
with  such  diseases  and  to  other  persons  likely  to  be  benefited  by  the  information 
therein  contained. 

In  response  to  special  requests  of  sanitarians  in  this  and  other  States  and  coun- 
tries, copies  of  the  Annual  Report,  proceedings  of  sanitary  conventions  held  in 
Michigan  under  the  auspices  of  the  State  Board  of  Health,  and  pamphlets  on  the 
restriction  and  prevention  of  the  dangerous  diseases,  have  been  sent  where  it  was 
thought  likely  to  benefit  public-health  interests.  However,  the  distribution  of  the 
Board’s  publications  has  been  much  less  than  usual,  because  of  the  lack  of  suffi- 
cient appropriation.  The  Annual  Report  for  1894  has  for  many  months  been  ready 
for  distribution,  but  no  funds  have  been  available  for  this  purpose.  The  appropria- 
tion for  1897  will  become  available  January  1,  1897,  and  it  is  hoped  that  the  1894 
Report  can  then  be  distributed.  The  Report  for  1895  is  nearly  ready  for  distribution. 
About  1,390  wrappers  have  been  addressed  for  use  in  sending  out  the  Report  of  this 
Board  for  1894. 

The  usual  record  of  the  distribution  of  publications  has  been  kept. 

Printing  and  Reprinting  Pamphlets,  Circulars,  Etc. 

During  this  quarter  no  pamphlet,  leaflet,  circular,  etc.,  has  been  reprinted  which 
would  necessitate  mention  here. 

In  December  the  new  slip  [234]  relative  to  life  saving  has  been  printed  to  the 
number  of  10,000  copies  and  already  widely  distributed,  in  letters  and  other  com- 
munications being  sent  out. 

This  new  slip  is  here  reproduced  as  follows: 


[234.] 

RECENT  SAVING  OF  SICKNESS  AND  LIFE  IN  MICHIGAN. 

EQUAL  TO  OVER  FIVE  MILLION  DOLLARS  SAVED  TO  THE  TAX  PAYERS. 


“The  Secretary  of  the  State  Board  of  Health  has  just  published  (in  Reprint  No. 
472)  official  statistics  on  the  results  of  the  life-saving  work  of  that  Board,  which 
show  that  through  compliance  with  the  recommendations  of  that  Board  during  the 
five  years,  1890-94,  there  were  probably  saved  to  the  people  of  Michigan  112,843 
cases  of  sickness  and  about  5,261  deaths,  from  the  four  diseases— diphtheria,  scarlet 
fever,  typhoid  fever  and  measles.  At  a very  low  estimate*  the  money  value 
thereby  saved  the  State  during  these  five  years  is  $5,097,800,  or  over  one  million  dol- 
lars per  year,  from  these  four  diseases.  If  all  the  dangerous  diseases  were  consid- 
ered, the  saving  would  undoubtedly  be  much  more. 

“The  State  Board  of  Health  exists  for  the  purpose  of  guarding  the  highest  inter- 
ests of  every  man,  woman  and  child  in  Michigan;  and,  if  it  had  the  cooperation  of 
all,  and  its  advice  was  fully  complied  with,  the  results  of  the  work  would  be  still 
more  effective.  As  it  is,  the  money  values  saved  to  the  people  of  the  State  greatly 
exceed  the  cost  of  the  public-health  work,  being,  in  fact,  nearly  half  as  much  as  the 
entire  amounts  required  to  sustain  the  State  government  and  all  the  State  institu- 
tions. From  an  unhealthful  State,  Michigan  is  fast  becoming  one  of  the  most  health- 
ful.”— State  Republican,  November  25,  1896. 

Special  Investigation  of  Sanitary  Conditions  at  Delray,  Mich. 

During  this  quarter  the  Secretary  had  received  letters,  petition,  etc.,  fom  Delay, 
Michigan,  relative  to  the  alleged  unsanitary  conditions  and  the  prevalence  of  dis- 
ease. After  conference  with  the  President  of  this  Board,  and  after  correspondence 
with  the  Health  Officer  and  others  at  Delray,  the  Secretary  investigated  the  com- 
plaints. The  Secretary’s  report  (hektograph  1741)  will  be  found  herewith.  [Not 
printed.] 


* “ The  basis  on  which  this  estimate  is  made  is  as  follows For  medical  attendance  and  other  neces- 
sary expenses  in  each  case  of  sickness,  $20 ; for  each  Mineral  preven’ed,  $40;  value  of  each  life  saved, 
$500.  (B  fore  the  late  war  a slave  was  worth  about  *800,  for  what  it  would  earn  over  and  above  its  cost 
of  main’ enance,  and  now  the  courts  count  an  average  person’s  life  worth  about  $5,000—  ten  times  the 
amount  used  in  this  e timate.)” 


ABSTRACT  OF  PROCEEDINGS  JANUARY  8,  1897. 


15 


Special  Biennial  Report  to  the  Present  and  to  the  Incoming  Governor  of 

Michigan. 

Since  the  last  meeting,  the  Secretary  has  transmitted  to  the  Hon.  John  T.  Rich, 
the  present  Governor,  and  lion.  Hazen  S.  Pingree,  the  incoming  Governor  of  Michi- 
gan, the  “Special  Biennial  Report  of  the  State  Board  of  Health,  relative  to  public- 
health  laws,  and  proposed  legislation  in  the  interests  of  public  health.”  The  report 
is  submitted  herewith.  (Hektograph  No.  1728.)  [Printed  on  preceding  pages.] 

Immigrants  Exposed  to  Contagious  Diseases  and  Destined  to  Settle  in 

Michigan. 

During  the  fourth  quarter  of  189(5,  notices  were  received  at  this  office  from  Dr.  J. 
H.  Senner,  U.  S.  Commissioner  of  Immigrants  at  New  York  City,  that  measles  had 
occurred  on  board  five  steamships,  and  scarlet  fever  on  board  one  steamship,  arriv- 
ing at  that  port,  and  having  on  board  passengers  destined  for  points  in  Michigan. 
Copies  of  these  notices  wore  mailed  to  the  health  officers  of  the  several  places  of 
destination,  as  under: — 


Steamship. 

Date  of 
arrival. 

Disease  on  board. 

Notices  sent  to  the  health 
officers  of : 

Friesland __  

Oct. 

6 

Measles 

Detroit,  Kalamazoo. 

Phdnicia 

Nov. 

8 

Greenville. 

Lucania 

14 

U 

Iron  Mountan,  Lansing. 

Lake  Linden,  Ishpeming. 

Iron  Mountain. 

St.  Louis 

22 

Scarlet  fever 

Campania 

u 

28 

Measles 

Karle  ruhe 

Dec. 

13 

(( 

Detroit. 

A notice  was  also  received  November  10,  from  the  Surgeon  of  the  SS.  Canada, 
which  arrived  at  Quebec,  November  5,  stating  that  measles  had  occurred  on  board. 
A copy  of  this  notice  was  sent  to  the  Health  Officer  at  Sault  Ste.  Marie,  one  of  the 
passengers  being  destined  for  that  city. 

Work  in  Connection  With  Sickness  Statistics. 

During  the  fourth  quarter  of  1896,  1,869  blank  report,  receipt  and  return  postal 
cards,  130  record  books,  64  printed  and  261  hektographed  circular  letters  regarding 
weekly  card-reports,  have  been  mailed  to  318  health  officers  and  regular  corres- 
pondents; 1,156  weekly  card-reports  have  been  received  and  entered  on  the  register; 
49  copies  of  the  hektographed  weekly  bulletin,  “Health  in  Michigan,”  were  mailed 
each  week,  and  110  copies  of  the  hektographed  monthly  bulletin,  “Health  in  Michi- 
gan” were  mailed  each  month.  These  bulletins  have  been  consolidated  for  this 
quarterly  report.  Considerable  work  has  been  done  on  the  compilation  of  the 
weekly  card-reports  of  sickness  during  the  year  1895,  for  the  Annual  Report  for 
1896. 


Health  in  Michigan  in  the  Fourth  Quarter  of  1896.  Communicable  Diseases. 

Compared  with  the  preceding  quarter,  (July,  August  and  September),  reports 
from  all  sources  show  typhoid  fever  to  have  decreased  by  an  average  of  twenty-seven 
places  per  month,  measles  to  have  decreased  by  an  average  of  three  places  per 
month,  scarlet  fever  to  have  increased  by  an  average  of  sixteen  places  per  month, 
whooping-cough  to  have  decreased  by  an  average  of  seven  places  per  month,  diphtheria 
to  have  increased  by  an  average  of  forty-three  places  per  month,  and  consumption 
to  have  increased  by  an  average  of  two  places  per  month,  in  the  fourth  quarter  of 
1806. 


16 


MICHIGAN  STATE  BOARD  OF  HEALTH. 


Meteorology  at  one  Central  Station , and  Sickness  Throughout  Michigan 
from  all  Causes , Fourth  Quarter  of  1896 , Compared  with 
the  Preceding  Quarter. 

A comparison  of  meteorological  conditions  of  the  fourth  quarter  of  1896,  with 
the  meteorological  conditions  of  the  preceding  quarter,  shows  the  prevailing  dir- 
ection of  the  wind  to  have  been  southwest,  (instead  of  south-southwest),  the  velocity 
2.8  miles  per  hour  greater,  the  temperature  28.24  degrees  lower,  the  absolute  humid- 
ity much  less,  the  relative  humidity  more,  the  day  and  night  ozone  less,  the  rainfall 
4.07  inches  less  and  the  depth  of  water  in  the  observation  well  at  Lansing  5 inches 
more  in  the  fourth  quarter  of  1896. 

Compared  with  the  preceding  quarter  (July,  August  and  September),  the  reports 
from  regular  observers  show  a marked  increase  of  diphtheria,  pneumonia,  influenza, 
tonsilitis,  bronchitis  and  pleuritis  and  a marked  decrease  of  diarrhea,  typhoid  fever, 
intermittent  fever,  and  remittent  fever  in  the  fourth  quarter  of  1896. 

The  Weather  and  the  Health  in  Michigan  in  the  Fourth  Quarter  of  1896, 
Compared  with  the  Average  for  the  Corresponding  Quarters 
in  the  Ten  Years,  1886-1895. 

A comparison  of  the  meteorological  conditions  of  the  fourth  quarter  of  1896,  with 
the  average  for  the  fourth  quarters  in  ten  years,  1886-1895,  shows  that  in  1896  the 
prevailing  direction  of  the  wind  was  the  same  (southwest),  the  velocity  was  .1 
of  a mile  per  hour  greater,  the  temperature  was  .44  of  a degree  higher,  the  rain- 
fall was  .86  of  an  inch  less,  the  absolute  humidity  was  less,  the  relative  humidity 
was  the  same,  the  day  and  night  ozone  were  less  and  the  depth  of  water  in  the 
observation  well  at  Lansing  was  11  inches  less. 

Compared  with  the  average  in  the  corresponding  quarters  in  the  ten  years,  1886- 

1895,  the  reports  from  regular  observers  indicate  that  intermittent  fever,  remittent 
fever,  consumption,  inflammation  of  bowels,  scarlet  fever,  erysipelas,  diarrhea  and 
inflammation  of  kidney  were  less  than  usuallv  prevalent  in  the  fourth  quarter  of 

1896. 


UNIVERSITY  OF  ILLINOIS-URBAN  A 
614.09  M58A  C001  1887-97 
Abstract  of  proceedings.  1886-1897. 


3 0112  088526360 


